Warning over new contraceptive pill risk

1.15 pm - By REBECCA WALSH

Women taking the oral contraceptive pills Estelle and Diane are being told to see their doctor after studies have found they face at least an eight times higher risk of suffering from blood clots.

The Ministry of Health is advising the 25,000 women estimated to take the pills to discuss this risk with a health practitioner before starting their next pack of pills.

It has advised practitioners to confine use of the pills to women with particular conditions, such as polycystic ovary syndrome and severe acne.

"Women need to discuss the risks and benefits of the pill with their health practitioner before making any decision to stop or change their preferred method of contraception," ministry spokesman Dr Stewart Jessamine said.

Dr Jessamine said the advice was being issued after a British study found the risk of blood clots with pills containing oestrogen and cyproterone acetate was "at least as great as that with third-generation oral contraceptives".

Estelle 35/35ED and Diane 35/35ED are the only medicines containing oestrogen and cyproterone acetate available in New Zealand.

They are used to treat conditions caused by an excess of the hormone androgen.

The risk of a blood clot for women taking third-generation pills is estimated to be eight times higher than for those who do not take the pill.

Of those who develop a clot about three per cent die.

Based on the number of women who take the combined pill, the ministry estimates about two women would die each year in New Zealand from a blood clot.

The ministry first issued advice on the increased risk of blood clots for women taking third-generation pills in 1996 and it repeated this in 1999. These warnings resulted in a dramatic decrease in their use.

In 1996 third-generation pills made up 60-70 per cent of the market compared with 25-30 per cent last year.

Until November last year the Centre of Adverse Reactions and Monitoring received 18 reports of blood clotting in women taking oral contraceptives containing cyproterone acetate. Fifteen of the women developed a pulmonary embolism but none was fatal.

Research by Otago University's Department of Preventive Medicine between 1990 and last year found 20 women using combined oral contraceptives were known to have died of a blood clot in the lungs. Of those, 15 were using third-generation pills and two were using pills containing cyproterone.

One woman the Herald spoke to had taken Diane for eight years and Estelle for the past year for polycystic ovary syndrome. She planned to visit her doctor immediately.

"It makes me worry because I have to weigh up my options. Do I put up with hellish pain every month ... or face the risk of a blood clot," the 28-year-old said.

"I really don't think I have any choice. I'll have to take a gamble."

nzherald.co.nz/health