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Wednesday, April 7, 1999 Published at 16:33 GMT 17:33 UK


U-turn over pill scare

The 1995 scare led to fears about all forms of contraceptive pill

An expert body has done a U-turn on the contraceptive pill which was at the centre of a scare over blood clots.

The 1995 scare over third generation pills has been credited with causing a 9% rise in abortions in the UK.

It was the result of advice from the Committee on the Safety of Medicines (CSM) that the pills, which contain oestrogen and either gestodene or desogestrel, should not be used as a first line form of contraception.

James Westhead reports: "The risk is now so small"
Its decision was based on research which suggested women using the pill were twice as likely to develop venous thrombembolism (VTE) as women who used older forms of the pill.

VTE is the formation of blood clots in the deep veins of the legs and pelvis. They may cause pain, swelling and redness of the legs and, in a handful of cases when they pass from the veins to the lungs, can be fatal.

A review by a government advisory body, the Medicines Commission, has, however, concluded that doctors can prescribe third generation pills like Mercilon, Triadene and Minulet, as a first line form of contraception.

Dr Jeremy Metters, the government's deputy chief medical officer, announced new guidance on the pill on Wednesday.

He said: "The review found no new safety concern in relation to third generation oral contraceptives."

Blood clots

He added that the Medicines Commission did confirm the CSM's concerns about increased risk of blood clots.

But it said that, as long as women were fully informed of the risks, which were small, it could be considered on an equal footing with other contraceptive pills.

Dr Metters said: "The Medicines Commission said that women must be fully informed of these very small risks of oral contraception.

"Provided they are, the type of pill is for the woman together with her doctor or other family planning professionals jointly to decide in the light of her individual medical history."

Dr Metters warned that pregnancy carried a much greater risk of VTE than using the third generation pill.

Leaflets on the new advice are being sent to doctors and family planning experts in June.

They will say it is estimated that 60 women per 100,000 develop VTE in pregnancy.

The spontaneous incidence of VTE in healthy women not taking a contraceptive is about five cases per 100,000 women per year.

The incidence in users of second generation pills is about 15 per 100,000 women per year of use.

The incidence in users of third generation pills is about 25 cases per 100,000 women per year of use.

The level of risk of VTE increases with age and is likely to be increased in women with other known risk factors for VTE, such as obesity.


Ann Furedi of the British Pregnancy Advisory Service (BPAS) welcomed the U-turn and said: "The advice given by the CSM in 1995, that these pills should not be prescribed was criticised by BPAS at the time for being unnecessary and alarmist.

"It was a disaster that should never have happened. It caused a massive hike in the rate of unintended pregnancies.

"It undermined general confidence in the pill. We still see women requesting abortion who wrongly believe the pill is dangerous."

The BPAS says abortions rose by 9% in 1996 after the scare and have remained at an increased level.

Previously, abortions had been falling.

Doctors also welcomed what they called "a return to a sensible prescribing policy".

A spokeswoman for the British Medical Association said the new advice would extend choice for women.

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