Some Birth Control Pills Safer Than Others

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Pills with equal doses of estrogen that contained the progestogen desogestrel had double the risk of the pills using levonorgestrel, the researchers found.

The Danish study of all women aged 15 to 49 from 1995 to 2005 found roughly the same association.

In general, the newer oral contraceptives have a higher risk than the older ones, Lidegaard said. "The fourth-generation pills are not safer than the first-generation pills, which we had not expected," he said.

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For women who want to use an oral contraceptive and are at higher risk because of obesity or a family history of venous thromboembolism, "it would be wise to take a second-generation product," Lidegaard said.

While the study looked at oral contraceptives marketed in Europe, the results apply to "all women in industrial countries," said Dr. Astrid van Hylckama Vlieg, a research fellow in the department of clinical epidemiology at Leiden University and a member of the Dutch research team.

"In the United States, you have several products we describe," she said.

It won't be easy for a woman to act on the information in the studies, she said. "By just looking at the package, you can't tell which generation of progestogen is used," she said. A consultation with the physician writing the prescription is advisable, she said.

"The message of these studies is that all the pills are effective as contraceptives if taken as directed, and that side effects have to do with the choice of pill," said Dr. Nick Dunn, a senior lecturer in medical education at the University of Southampton Medical School in England, who wrote an accompanying editorial.

While the risk of venous blood clots is very small, it cannot be disregarded, Dunn said. "Women with any sort of family history should think very carefully before taking any contraceptive pill," he said. "These papers strongly suggest that there are safer pills among the choices that are available."

More information

Learn about oral contraceptives from the U.S. National Library of Medicine.

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