Women clearer on pill decisions

A continuing drop in prescriptions for third-generation contraceptive pills shows that women are making informed choices and following medical advice, Pharmac says.

Figures provided by the Government drug-funding agency for the year to last June show prescriptions for third-generation pills 13,000 lower at 68,864.

The drop follows a plummet in third-generation pill users in 1999-2000, after the contraceptives were linked to increased blood clot risk and several deaths.

Hamilton 16-year-old Stacey Brindle, who was taking Estelle 35D to treat mild acne, died last July from a pulmonary embolism. A 26-year-old woman on the third-generation pill Mercilon died in October 2000.

Third-generation prescriptions fell by 116,000 in the year to June 2000, after the blood clot link. They dropped another 23,000 the following year.

The five-year trend shows the number of women taking the once popular third-generation pills is now about a fifth of what it was in 1997 (335,956).

Prescriptions for the second-generation pills rose from 171,643 in 1997 to 295,090 last year.

"The medical profession are much more aware of the fact that second-generation oral contraceptives are safer than the third," Pharmac medical director Peter Moodie said.

"I'm not aware of any research that suggests that third generation is safer."

Dr Moodie said that, when first introduced to New Zealand, third-generation pills offered fewer side effects, such as greasy hair, acne and increased irritability, than others.

"It was thought that by having fewer side effects, this would be a big breakthrough, but once it got out into the population and many, many people started to take them, we saw this small but significant risk of pulmonary embolism," he said.

Dr Moodie said promotion of the new pills to doctors saw a good uptake in New Zealand.

But in fact "third-generation pills double or treble your risk of things like pulmonary embolism".

Dr Moodie agreed that New Zealand women were now making informed choices, based on medical advice.

"My recommendation would be to start with a second-generation pill, and if you have side effects, okay, we can move it to the third generation," Dr Moodie said.

"It doesn't matter what medications you're taking, they carry a risk. You really should make sure you're on it for a good reason and you should be taking the safest medication available."

He said smokers who took either generation of oral contraceptive were at increased risk of blood clots.

Second-generation pills are fully subsidised, whereas third-generation pills are only partly funded.

- NZPA