Don't panic over pill, women told

By Catherine Masters

Women are being urged not to panic after revelations that six women died in six years from blood clots while using third-generation contraceptives.

GPs and Ministry of Health officials say women should not rush out and change their contraceptive, nor should they stop taking it.

About 65 per cent of New Zealand women take the third-generation, often low-hormone, pills called mercilon, marvelon, femodene and minulet. They differ from older pills in that they contain progestogens called desogestrel or gestodene.

A British study in 1995 showed they were twice as likely to lead to blood clots, but that study has been disputed.

Dr Stewart Jessamine, a ministry of health senior medical adviser, said yesterday that the ministry had commissioned research into why the women had died and whether six was an unusually high number. The women died between 1993 and last year.

He said there was no scandal but the ministry had published the figures to remind doctors and patients that risks were attached to the pills.

Dr Jessamine said the use of the pills was very high among New Zealand women compared with other countries, but that could be because the low-dose pills were considered safer than older generation ones.

But Sandra Coney, a women's health campaigner and member of the ministry's working committee set up to examine the issue, said the ministry's low-key approach had contributed to the high number of women taking the pills.

She said the working committee had originally intended to advise doctors to preferentially prescribe other brands of oral contraceptives but the backlash was furious. Drug companies bombarded GPs with dossiers contradicting the studies that had shown the risk and the ministry was threatened with legal action.

Sandra Coney said the Royal New Zealand College of Obstetricians and Gynaecologists said it would publicly dissociate itself from the advice, and Family Planning said the studies were biased and couldn't be trusted.

"The ministry bowed to the pressure ... and the advice [in 1996] was now only to `consider prescribing' other brands."

Dr Philip Rushmer, GP spokesman for the Medical Association, said blood clotting was a one-in-10,000 risk even on the older pills.

The new pills doubled that - but the condition was more common in some women anyway - smokers and those overweight.

The third-generation pills were beneficial in that they were better tolerated with fewer side-effects.