After having studied the actual benefit of the so-called 3rd generation contraceptive pills (that is to say the pills containing the progestogen desogestrel or gestodene or norgestimate), the Haute Autorité de Santé has finally issued an unfavorable opinion, considering that there was, with this generation, a twice as high risk of thrombo-venous complications (phlebites). Following this opinion, the Ministry of Health has therefore decided to no longer reimburse this class of pills.
A few months ago, the very serious British medical journal began to cause panic among women on the third generation pill, by publishing a Danish study conducted on 1.7 million women on the pill. This study also showed that the risk of venous thrombosis is twice as high with a so-called third generation pill which contains desogestrel, gestodene or drospirenone (the list of pills here) than an older, second generation pill that contains levonorgestrel.
A few days later, the American Medicines Agency (the Food and Drug Administration) came to support this study by publishing a report which indicates that this type of pills increases the risk of accidents by 1.5 to 2 compared to more pills. old. Since then, forums and blogs have been in turmoil: whether or not to change the pill, the patients who have been prescribed a third-generation pill are wondering.
This risk of venous thrombosis is not new since in 1995 already four international studies showed an increased risk of venous thromboembolism (VTE) with the pills. containing desogestrel or gestodene. And in its recommendations, the Haute Autorité de santé indicates that these pills should only be prescribed as a second-line option, only if the older pills have too many side effects. For the French Agency for the Safety of Health Products (Afssaps), for around 100,000 women using third-generation contraceptives, the number of cases of venous thrombosis fluctuates between 20 and 40 per year.
What is venous thrombosis?
A venous thrombosis is a small clot of blood that gets stuck in a vein. Main risk: If this clot breaks free and travels to your lungs, it can block the oxygenation process. Hence the (legitimate) concern of women who have been prescribed oral contraception supposed to cause fewer side effects and in particular fewer cardiovascular risks.
But that women who are on the third generation pill be reassured: the risk of accident (low) is present especially in the first months following the initial intake. However, in making the decision to end reimbursement for this class of pill, the health authorities expect that women who used these pills will choose another method of contraception (reimbursed if they wish) when they renew their prescription.
According to these health authorities, women should not hesitate to ask their gynecologist questions before prescribing their contraceptive pill, remembering to talk about their family history. For Dr. Elia, our expert gynecologist, “there is no reason not to immediately offer a second generation pill, especially since most of them are reimbursed and inexpensive”.
Note that 3rd generation pills will no longer be reimbursed as of September 30, 2013.
