Third-generation pill poses no greater risk says study

By NAOMI LARKIN

New research has challenged fears that third-generation contraceptive pills - linked with nine deaths in New Zealand - are putting women at greater risk.

The study, just published in the British Medical Journal, compared the number of blood clots in women in the three years before and after the 1995 pill scare in Britain.

It found that although the use of the third-generation oral contraceptives fell over the period - from 54 per cent to 14 per cent in women aged 15 to 49 - the rates of clots among pill takers did not alter significantly.

"The newer types of combined oral contraceptive pills do not put women at increased risk of clots in the veins, contrary to previous information," the study said.

No evidence of differences was seen in any of the age groups. Data was taken from 304 general practices throughout the country.

But a Ministry of Health senior medical adviser in Wellington, Dr Stewart Jessamine, said yesterday that the report had to be put into perspective. "What you must do is take the sum of evidence rather than each individual study as it comes along."



Since 1995 the ministry had reviewed each published study and its advice to women remained the same - that they should talk to their doctors about which pill suited them best, Dr Jessamine said.

"They should be informed by their doctors that there is an increase in risk with the third-generation pills. And that if they have a family history of blood clots they would be better off either on a second-generation pill or possibly not on a hormonal form of contraception."

Women's Health Action executive director Sandra Coney last night pointed out that the study was funded by Organon, the firm that distributes two of the four pill brands involved.

Nine NZ women have died from blood clots while using third-generation oral contraceptives since they were first available in 1982. This is 50 per cent higher than the expected rate.

Seven were aged between 19 and 32 and the other two between 33 and 44. All but one were found to have been at risk of blood clots. Risk factors include obesity, family history of blood clots and bad varicose veins.

The clots occur in the veins of the legs, causing swelling, tenderness and pain. They may be fatal when pieces of the clot travel to the lungs.

Third-generation-pills, such as Femodene, Minulet, Marvelon and Mercilon, differ from older pills in that they contain progestogens called desogestrel or gestodene. The risk is twice as high for women taking third-generation pills as for those on second-generation contraceptives.

Medical Association chairman Dr Pippa MacKay welcomed the British findings, saying they were in keeping with results from other international studies. There had been a lot of "hype" around the third-generation pills, much of it unjustified.