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Oral contraceptives and thromboembolic disease.

Two case studies are presented where patients developed deep vein thrombosis while on oral contraceptives (OCs). In both cases following treatment OC use was not reinitiated. While the association between OC use and thromboembolic disease is widely accepted it is not a proven conclusion. Conflicting conclusions are seen in the numerous existing retrospective studies and in an attempt to improve upon those a prospective study was undertaken in Puerto Rico between 1961 and 1970. There was an OC group and a vaginal contraceptive group and there was a total of 30 deaths 12 among the OC group. A follow-up study concerning thrombophlebitis in the original population arrived at the conclusion that there was no statistical difference between the two groups with respect to thrombophlebitis. Another study cited indicates that for each group there was a lower thromboembolic rate for users of OCs. It is clear then that the literature dealing with this subject is confusing and that it is unlikely that a valid statistical association between the two exists. It is necessary however that patients be informed about the status of OCs and thromboembolism and that in discussing the morbidity rate of OC users that must be weighed against the morbidity of those who would have become pregnant using less effective contraception.