Oral Contraceptives: A 50-Year Experience of Overall Cardiovascular Safety

After the introduction of combined oral contraceptives (COC) containing estrogen and progestin in 1960, the first case reports linking deep vein thrombosis and pulmonary thromboembolism (VTE) with COC use appeared in the literature. The rates of VTE have declined over the years due to a reduction in the estrogen dose in OCs.  The other major cardiovascular sequelae include myocardial infarction and stroke.  Both are rare and factors such as hypertension and smoking are major contributors to the risk. A summary of the use of current combined OCs and their association with a low attributable risk of VTE and to a limited extent with increased risk of stroke and Myocardial Infarction will be presented.