PMID: 9168374Jan 1, 1997Paper

The estrogen component of OCs: cardiovascular benefits and risks

International Journal of Fertility and Women's Medicine
R T Burkman

Abstract

The relationship of oral contraceptive (OC) use to risk of venous thrombolism, stroke, and myocardial infarction continues to be evaluated. The estrogen component of combination OCs, which is primarily responsible for maintaining the endometrium and minimizing breakthrough bleeding (BTB) and spotting, was the initial focus of clinical and epidemiologic interest following early reports of an increased risk of vascular events with high-estrogen-dose formulations. OC estrogen continues to hold attention; current areas or interest include the relationship of estrogen to laboratory changes in hemostatic, lipid/lipoprotein, and carbohydrate variables, and, more important, to their possible clinical consequences. The historical view that OC-induced lipoprotein changes are responsible for observed increases in vascular risk in OC users is being debated, but the preponderance of evidence suggests that CO-related vascular disease is most likely due to thrombosis rather than atherosclerosis. This issue is made somewhat moot, however, by cumulative epidemiologic data indicating that although some combination OCs containing < or = 35 micrograms estrogen appear to produce a slight increase in the risk of venous thromboembolism, they have no ...Continue Reading

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