VTE risk by hormonal type
| Hormonal type . | Example agents . | Baseline risk in nonusers . | Adjusted RR (95%) . | Absolute risk . |
|---|---|---|---|---|
| Combined hormonal contraceptives | ||||
| COCsa | 1.9-3.7/10 000 PY29,30 | Overall: 3.5 (2.9-4.3)32 | - | |
| First generation | EEb/norethindrone | 1.9-3.7/10 000 PY29,30 | 3.2 (2.0-5.1)32 | 3.7-16.1/10 000 PY29 |
| Second generation | EE/LNG EE/norgestrel | 1.9-3.7/10 000 PY29,30 | 2.92 (2.23-3.81)29 | 5-8/10 000 PY29 |
| Third generation | EE/desogestrel; EE/gestodene | 1.9-3.7/10 000 PY29,30 | 6.61 (5.60-7.80)29 | 9-12/10,000 PY29 |
| Fourth generation/unclassified | EE/drosperinone; EE/cytoproterone acetate | 1.9-3.7/10 000 PY29,30 | 6.37 (5.43-7.47)29 | 7-9/10 000 PY29 |
| Transdermal patch | EE/norelgestromin; EE/LNG | 2.1/10 000 PY35 | 7.9 (3.5-17.7)35 | 9.7/10 000 exposure y35 |
| Vaginal ring | EE/etonogestrel; EE/nestorone | 2.1/10 000 PY35 | 6.5 (4.7-8.9)35 | 7.8/10 000 exposure y35 |
| Progestin-only contraceptives | ||||
| IUS | LNG | 25-29 y: 2.4/10 000 PY63 | 0.6 (0.2-1.5)37 | 1.4/10 000 PYc |
| Low-dose POP (<5 mg) | Norethindrone; desogestrel; drosperinone | 25-29 y: 2.4/10 000 PY63 | 0.9 (0.6-1.5)37 | 2.2/10 000 PYc |
| High-dose POP for menstrual bleeding (>5-30 mg) | Norethindrone acetate; medroxyprogesterone acetate | 25-29 y: 2.4/10 000 PY63 45-49 y: 5.4/10 000 PY63 | 5.3 (1.5-18.7)40 5.92 (1.16-30.1)41 | 25-29 y: 12.7/10 000 PYc 45-49 y: 28.6/10 000 PYc |
| Injectable DMPA | Medroxyprogesterone acetate | 25-29 y: 2.4/10 000 PY | 2.7 (1.3-5.5)37 | 6.5/10 000 PYc |
| Subdermal implant | Etonogestrel; LNG | 2.1/10 000 PY | 1.4 (0.6-3.4)35 | 1.7/10 000 exposure y35 |
| Hormonal type . | Example agents . | Baseline risk in nonusers . | Adjusted RR (95%) . | Absolute risk . |
|---|---|---|---|---|
| Combined hormonal contraceptives | ||||
| COCsa | 1.9-3.7/10 000 PY29,30 | Overall: 3.5 (2.9-4.3)32 | - | |
| First generation | EEb/norethindrone | 1.9-3.7/10 000 PY29,30 | 3.2 (2.0-5.1)32 | 3.7-16.1/10 000 PY29 |
| Second generation | EE/LNG EE/norgestrel | 1.9-3.7/10 000 PY29,30 | 2.92 (2.23-3.81)29 | 5-8/10 000 PY29 |
| Third generation | EE/desogestrel; EE/gestodene | 1.9-3.7/10 000 PY29,30 | 6.61 (5.60-7.80)29 | 9-12/10,000 PY29 |
| Fourth generation/unclassified | EE/drosperinone; EE/cytoproterone acetate | 1.9-3.7/10 000 PY29,30 | 6.37 (5.43-7.47)29 | 7-9/10 000 PY29 |
| Transdermal patch | EE/norelgestromin; EE/LNG | 2.1/10 000 PY35 | 7.9 (3.5-17.7)35 | 9.7/10 000 exposure y35 |
| Vaginal ring | EE/etonogestrel; EE/nestorone | 2.1/10 000 PY35 | 6.5 (4.7-8.9)35 | 7.8/10 000 exposure y35 |
| Progestin-only contraceptives | ||||
| IUS | LNG | 25-29 y: 2.4/10 000 PY63 | 0.6 (0.2-1.5)37 | 1.4/10 000 PYc |
| Low-dose POP (<5 mg) | Norethindrone; desogestrel; drosperinone | 25-29 y: 2.4/10 000 PY63 | 0.9 (0.6-1.5)37 | 2.2/10 000 PYc |
| High-dose POP for menstrual bleeding (>5-30 mg) | Norethindrone acetate; medroxyprogesterone acetate | 25-29 y: 2.4/10 000 PY63 45-49 y: 5.4/10 000 PY63 | 5.3 (1.5-18.7)40 5.92 (1.16-30.1)41 | 25-29 y: 12.7/10 000 PYc 45-49 y: 28.6/10 000 PYc |
| Injectable DMPA | Medroxyprogesterone acetate | 25-29 y: 2.4/10 000 PY | 2.7 (1.3-5.5)37 | 6.5/10 000 PYc |
| Subdermal implant | Etonogestrel; LNG | 2.1/10 000 PY | 1.4 (0.6-3.4)35 | 1.7/10 000 exposure y35 |
RRs reported with EE 30-40 µg when available. Lower estrogen doses carry a lower VTE risk.29
Norgestimate may be listed as either second or third generation, but its risk profile is similar to LNG.29
Calculated using the baseline VTE incidence in nonusers and the RR, when the absolute VTE risk was not reported.