Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2021
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Research

Higher risk of venous thrombosis associated with drospirenone-containing oral contraceptives: a population-based cohort study

Naomi Gronich, Idit Lavi and Gad Rennert
CMAJ December 13, 2011 183 (18) E1319-E1325; DOI: https://doi.org/10.1503/cmaj.110463
Naomi Gronich
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: gronichn@clalit.org.il
Idit Lavi
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gad Rennert
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF
Loading
Submit a Response to This Article
Compose Response

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
References
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Minimum 7 characters.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'. Minimum 12 characters.
Your organization, institution's or residential address.
Statement of Competing Interests

Vertical Tabs

Jump to comment:

  • Drospirenone and venous thromboembolism; Do prescribing practices impose bias?
    Steven T Bird
    Posted on: 20 December 2011
  • Drospirenone may Increase Thrombosis by Decreasing DHEA
    James M. Howard
    Posted on: 14 December 2011
  • Posted on: (20 December 2011)
    Drospirenone and venous thromboembolism; Do prescribing practices impose bias?
    • Steven T Bird, Pharmacist

    Your recent article on drospirenone and venous thromboembolism (VTE) highlighted vast differences between drospirenone and second-generation oral contraceptives (OC) users for smoking [26.28 % versus 18.48%] and obesity [13.41% versus 26.44%] [1]. These differences were not observed in the European Active Surveillance Study which interviewed patients at baseline [2], or the INGENIX study [3], which sampled 10% of patien...

    Show More

    Your recent article on drospirenone and venous thromboembolism (VTE) highlighted vast differences between drospirenone and second-generation oral contraceptives (OC) users for smoking [26.28 % versus 18.48%] and obesity [13.41% versus 26.44%] [1]. These differences were not observed in the European Active Surveillance Study which interviewed patients at baseline [2], or the INGENIX study [3], which sampled 10% of patients to assess for these covariates. Do you think this reflects differences in prescribing practices between Israel and either Germany or the United States? Might these differences suggest the presence of other potential unmeasured confounders?

    The selective prescribing of drospirenone in patients with polycystic ovary syndrome (PCOS), discussed at the December 8th FDA advisory committee meeting, raised concern for confounding by indication. We recently acquired an OC cohort in IMS data to evaluate gall bladder disease with use of drospirenone [4]. In further evaluation, we found that 6.05% of women taking drospirenone/ethinyl-estradiol 0.03mg had PCOS, compared to 2.09% of women taking levonorgestrel/ethinyl-estradiol 0.03mg. (unpublished: 2011) Because women with PCOS are known to represent a population at high risk for VTE, this could be a potential issue for previous studies. Do you have data on the prevalence of polycystic ovary syndrome (PCOS) in your study population?

    I would appreciate any comments you provide.

    References

    1. Gronich N, Lavi I, Rennert G. Higher risk of venous thrombosis associated with drospirenone-containing oral contraceptives: a population- based cohort study. [published online ahead of print November 7, 2011]. CMAJ. 2011:doi:10.1503/cmaj.110463.

    2. Dinger JC, Heinemann LA, Kühl-Habich D. The safety of a drospirenone-containing oral contraceptive: final results from the European Active Surveillance Study on oral contraceptives based on 142,475 women-years of observation. Contraception. 2007;75:344-354.

    3. Eng PM, Seeger JD, Loughlin J, et al. Supplementary data collection with case-cohort analysis to address potential confounding in a cohort study of thromboembolism in oral contraceptive initiators matched on claims-based propensity scores. Pharmacoepidemiol Drug Saf. 2008;17:297 -305.

    4. Etminan M, Delaney JA, Bressler B, et al. Oral contraceptives and the risk of gallbladder disease: a comparative safety study. CMAJ 2011;183(8):899-904.

    Conflict of Interest:

    This letter represents the opinion of the author and not those of the Food and Drug Administration.

    Show Less
    Competing Interests: None declared.
  • Posted on: (14 December 2011)
    Drospirenone may Increase Thrombosis by Decreasing DHEA
    • James M. Howard, Biologist
    • Other Contributors:

    It is my hypothesis that low DHEA may be the cause of venous thrombosis. Low DHEA may be connected with many major symptoms resulting in thrombosis. "Thrombosis May Be Caused by Low DHEA" http://anthropogeny.com/Thrombosis%20May%20Be%20Caused%20by%20Low%20DHEA.htm .

    Drospirenone has been demonstrated to reduce DHEAS, the precursor of DHEA, by 20-50% (Contraception 2011; 82: 276-80).

    Since the mechan...

    Show More

    It is my hypothesis that low DHEA may be the cause of venous thrombosis. Low DHEA may be connected with many major symptoms resulting in thrombosis. "Thrombosis May Be Caused by Low DHEA" http://anthropogeny.com/Thrombosis%20May%20Be%20Caused%20by%20Low%20DHEA.htm .

    Drospirenone has been demonstrated to reduce DHEAS, the precursor of DHEA, by 20-50% (Contraception 2011; 82: 276-80).

    Since the mechanism whereby oral contraceptives exert their effects may be by reducing DHEA, drospirenone may be a very effective oral contraceptive. However, the fact that drospirenone may decrease DHEA beyond certain levels in certain individuals may account for the increase in thrombosis caused by drospirenone

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 183 (18)
CMAJ
Vol. 183, Issue 18
13 Dec 2011
  • Table of Contents
  • Index by author

Article tools

Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Higher risk of venous thrombosis associated with drospirenone-containing oral contraceptives: a population-based cohort study
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Higher risk of venous thrombosis associated with drospirenone-containing oral contraceptives: a population-based cohort study
Naomi Gronich, Idit Lavi, Gad Rennert
CMAJ Dec 2011, 183 (18) E1319-E1325; DOI: 10.1503/cmaj.110463

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Higher risk of venous thrombosis associated with drospirenone-containing oral contraceptives: a population-based cohort study
Naomi Gronich, Idit Lavi, Gad Rennert
CMAJ Dec 2011, 183 (18) E1319-E1325; DOI: 10.1503/cmaj.110463
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Interpretation
    • Footnotes
    • References
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review
  • FSRH Guideline (January 2019, amended November 2020) Combined Hormonal Contraception
  • Low dose oestrogen combined oral contraception and risk of pulmonary embolism, stroke, and myocardial infarction in five million French women: cohort study
  • Use of combined oral contraceptives and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases
  • Exposure to combined oral contraceptives and risk of venous thromboembolism: a protocol for nested case-control studies using the QResearch and the CPRD databases
  • Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis
  • Combined hormonal contraceptives and the risk of venous and arterial thromboembolism and cardiovascular death: misuse of automated databases
  • Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10
  • Google Scholar

More in this TOC Section

  • Rates of rebleeding, thrombosis and mortality associated with resumption of anticoagulant therapy after anticoagulant-related bleeding
  • Trends in prevalence of chronic disease and multimorbidity in Ontario, Canada
  • COVID-19 in patients undergoing long-term dialysis in Ontario
Show more Research

Similar Articles

Collections

  • Topics
    • Venous disease
    • Reproductive health, infertility & pregnancy

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of the resources on this site in an accessible format, please contact us at cmajgroup@cmaj.ca.

Powered by HighWire