Hormonal contraceptives carry varied risk of VTE- Combined pills most unsafe, Study Finds

The research, which evaluates a wide range of hormonal contraceptive methods—including combined oral contraceptive pills, vaginal rings, patches, progestin-only pills, intrauterine devices (IUDs), implants, and injections—found significant differences in VTE risk based on the type of contraceptive used.

The study revealed that combined oral contraceptives, particularly those containing third-generation progestins, were associated with the highest rates of VTE. These contraceptives, which combine estrogen and progestin, have long been known to carry an increased risk of clot formation. However, the research emphasizes the notable variation in risk depending on the specific type of progestin used. The findings indicate that third-generation progestins, in particular, may further elevate the VTE risk compared to other formulations.

In contrast, the study found no significant difference in VTE risk for individuals using intrauterine devices (IUDs) compared to those who did not use any contraception. IUDs, which work by preventing fertilization without affecting blood clotting, appear to pose little to no risk for VTE, making them a favorable option for those seeking a low-risk contraceptive method.

For patches and implants, the data on VTE risk remained inconclusive due to the limited amount of research available. The study noted that while these methods may carry some risk, it remains unclear how they compare to other hormonal methods for VTE incidence, warranting further investigation.

The variation in VTE risk across different hormonal contraceptives underscores the importance of personalized contraceptive counseling. Healthcare providers are encouraged to consider individual patient factors, such as medical history and risk factors for blood clotting when recommending contraception. By tailoring contraceptive choices to the specific needs of each patient, the risk of adverse events like VTE can be minimized, ensuring safer and more effective contraception options.

"This study contributes to ongoing efforts to better understand the safety profiles of hormonal contraceptives, helping to guide both clinicians and patients in making informed decisions about family planning and contraceptive use," the researchers concluded.

Reference:

Yonis HGH, Mørch LS, Løkkegaard E, et al. Contemporary Hormonal Contraception and Risk of Venous Thromboembolism. JAMA. Published online February 10, 2025. doi:10.1001/jama.2024.28778