The latest study to be published claiming 'higher' venous thromboembolism risk in women using the medium-acting reversible contraceptives (patch and vaginal ring), and possibly also the long-acting reversible subdermal contraceptive implant, is extremely concerning.
These results will be picked up by commissioners and prescribing advisers who will then make decisions about restricting the use of these highly effective, popular contraceptives based on a poor evidence base.
This study, like previous ones based on the Danish registry, fails to compare like with like and does not include any data about the known risk factors for venous thromboembolism – smoking, family history and BMI greater than 30.
The data about the subdermal implant is very dubious, with small numbers and a relative risk of 1.4 with wide confidence intervals (0.6-3.4).
We have done well nationally with reductions in teen pregnancy and abortions over the past few years.
Good open access to a range of options has allowed women to make an informed
choice of contraceptive method.
By having a choice they are more likely to comply with the requirements of their chosen method, which maximises efficacy and reduces the numbers of unplanned and unwanted pregnancies.
If commissioners and prescribing advisers make knee-jerk decisions based
on poor studies such as this one we will be reduced to providing a range of cheaper, older, less well-tolerated options to women – and we are likely to see unplanned pregnancy rates increase again.
From Dr Anne Connolly, Bradford, Chair of the Primary Care Women's Health Forum
