The birth control pill is one of the most ubiquitous medications for women. It is the leading form of contraception for women between the ages of 15 and 29. In the United States and the rest of the developed world, over 17% of all women between the ages of 15 and 44 are on the pill. But is it safe? Is modern science making the pill safer? . . .

In Britain, where 28% of women of reproductive age are on the pill, researchers set out to answer this question. And the answer they got is not good. The pill is getting less safe, not more.

They found that women taking any form of combined birth control pill--one containing estrogen and progesterone--were 2.97 times more likely to develop a blood clot in a deep vein in the leg or pelvis than women who were not taking a birth control pill. 

That the pill can cause blood clots is not really news. The bad news is that the risk is higher with the newer birth control pills: 1.5-1.8 times higher. The older generation of birth control pills are about 2.5 times more likely to cause a blood clot; the newer generation of birth control pills is about 4 times more likely to cause a blood clot. The risk was higher for all the latest generation of birth control pills but one (for which the risk was the same as the old generation pill). 

The risk was elevated for drospirenone, gestodene and, especially, desogestrel and cyproterone.

BMJ 2015;350:h2135

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