Protrhombotic Effects of Contraceptives

Giovanni      Fazio; Filippo      Ferrara; Giuseppe      Barbaro Gullotti Alessandro; Giovanni      Ferrro; Giuseppina      Novo; Salvatore      Novo

Abstract

The use of oral contraceptives first became widespread some 40 years ago, and reports of an excess risk of cardiovascular disease among women who used these agents soon followed. Few drugs have been the object of such intensive epidemiological research, the outcome of which has provided clinicians with detailed information about risks not only of specific thrombotic diseases but also important non-contraceptive benefits from the pill. Recently, oral contraceptives have been classified by some according to “generation” (first, second, third, and most recently, fourth generation): first-generation formulations containing lynestrenol or norethindrone, secondgeneration formulations containing levonorgestrel, third-generation formulations containing desogestrel or gestodene, and oral contraceptives containing an estrogen and other progestagens (cyproterone or norgestimate) or a progestagen alone. The results of several studies was that the use of the older high-dose oral contraceptives increased the risk of cardiovascular disease by modifying the Low-density lipoprotein and High-Density lipoprotein cholesterol level, increasing triglyceride serum level, reducing glucose tolerance, raising blood pressure, and promoting clotting mechanisms. In this review we investigate the mechanism of the oral contraceptives and performed a risk assessment of every generation.

Keywords: Oral contraceptives, cardiovascular risk, generation, levonogestren, gestodene, desogestrel, Protrhombotic Effects, Contraceptives, cardiovascular dis-ease, thrombotic diseases, lynestrenol, norethindrone, levonorgestrel, estrogen, progestagens, cyproterone, norgestimate, progestagen alone, High-Density lipoprotein, triglyceride serum level, glucose tolerance, blood pressure, clotting mechanisms, cardial infarction, pulmonary embolism, venous thrombosis, atherosclerosis, sex hormones, monophasic gestodene, preparation, HDL, nandrolone derivatives, medroxyprogesterone acetate, diabetes mellitus, insulin, diuretics, antisympathetic agents, an-timineralocorticoid effect, fibrinolytic pathways, prothrombin, factor VII, factor VIII, factor X, fibrinogen, dislypidemia, coronary thrombosis, coronary heart disease