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Human Reproduction Update, Vol.5, No.6 pp.639-653, 1999
© European Society of Human Reproduction and Embryology 1999; all rights reserved

Clinical implications. Avoiding problems in clinical practice after the pill scare

A Mills

Department of Gynaecology, University College Hospitals London, The United Elizabeth Garrett Anderson Hospital and Hospital for Women Soho, 144 Euston Road, London NW1 7AS, UK

Abstract

The publications of 1995 and 1996 on the risk of venous thrombosis associated with the use of the combined oral contraceptive pill (COC) suggested that the risks were lower than previous estimates. The debate, which ensued, ensured that the safety of the COC with regard to arterial and venous disease was reassessed. This review details the importance of contraception for public health. It reassesses critically current prescribing practice in the light of the new publications on Factor V Leiden, arterial and venous disease. Methods of communicating information about the COC are assessed, and the difficulties of transmitting complex scientific data to health care professionals and the general public are debated. The importance of attempting to quantify the benefits and risks of the COC and explaining them in the context of other life events is emphasized.

Key words: combined oral contraceptive/communication/contraception/pill scare/public health


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