Thrombotic Risk Associated with Drospirenone-Containing Contraceptives

Introduction to Thrombotic Risk

• The European Society of Cardiology suggests that combined oral contraceptives containing drospirenone plus estrogen carry an elevated venous thromboembolism risk, with a relative risk of venous thrombosis 50-80% higher compared to levonorgestrel-containing combined oral contraceptives 1, 2
• The American Academy of Dermatology indicates that the VTE risk with drospirenone-containing combined oral contraceptives is approximately 10 per 10,000 woman-years, compared to 3-9 per 10,000 woman-years for standard combined oral contraceptives and 1-5 per 10,000 woman-years for non-users 2, 3

Thrombotic Risk Profile

• The American Heart Association implies that all combined oral contraceptives increase VTE risk due to their estrogen content, with the specific progestin type modulating this baseline estrogen-related risk 1, 2
• The hazard ratio for venous thromboembolism with drospirenone/ethinyl estradiol is 1.77 (95% CI 1.33-2.35) compared to low-dose estrogen comparators, according to the European Heart Journal 2