2nd generation contraceptive pills associated with the lowest risk of blood clots

16 September 2015

Scientific evidence shows that the older 2nd generation contraceptive pills are associated with a lower risk of blood clots compared to the newer 3rd and 4th generation contraceptive pills.

Consequently, the Danish Health and Medicines Authority still advises doctors to prescribe 2nd generation contraceptive pills instead of 3rd and 4th generation contraceptive pills.

However, 3rd and 4th generation contraceptive pills are still on the market, and women can still choose this type of contraceptive pills in consultation with a doctor.

”Many women prefer to use 3rd and 4th generation contraceptive pills, and if they wish to continue, we have to accept their choice. 3rd and 4th generation contraceptive pills are authorised in the EU and still on the market. And it is perfectly legal for doctors to continue prescribing 3rd and 4th generation contraceptive pills to the women who prefer this type of pill. But they should of course be informed of the risks of using 3rd and 4th generation contraceptive pills,” says Line Michan from Pharmacovigilance & Medical Devices at the Danish Health and Medicines Authority.

The Danish Health and Medicines Authority recommends that as many women as possible use 2nd generation contraceptive pills; and the consumption of 2nd, 3rd and 4th generation contraceptive pills shows that both doctors and pill users comply with our recommendations, because the sale of 2nd generation contraceptive pills in recent years have by far exceeded the sale of 3rd and 4th generation contraceptive pills. 

Salget af p-piller fordelt på generationer (DDD)

Figure 1. Development in the sale of contraceptive pills by generation

Finally, it is important that doctors evaluate the risk factors for blood clots prior to the prescription of contraceptive pills and at regular intervals. The risk factors include hypertension, smoking, genetic factors and age. Women should also be informed about the early symptoms of blood clots, such as chest pain or shortness of breath.

Facts about contraceptive pills*

1st generation contraceptive pills: Qlaira®
The contraceptive pills contain the progesterones norethisterone or dienogest

2nd generation contraceptive pills: Anastrella®, Cilest®, Ethinylestradiol/levonorgestrel "Copharma", Etnor, Femicept, Loette® 28, Microgyn®, Microstad, Rigevidon.
The contraceptive pills contain the progesterones norgestrel, levonorgestrel and norgestimate

3rd generation contraceptive pills: Daisynelle®, Denise®, Femelle, Femigen, Femistad, Gestinyl®, Gestodilat®, Harmonet®, Marvelon®, Mercilon®, Minero, Minulet®, Modina.
The contraceptive pills contain the progesterones desogestrel and gestodene

4th generation contraceptive pills: Cleosensa, Dretine®, Estron® 28, Finminette®, Stefaminelle®, Veyann®, Yasmin 28®, Yasmin®, Yasminelle 28®, Yasminelle®, Yaz®.
The contraceptive pills contain the progesterone drospirenone

* The product names on this list change continuously, so ask your doctor if the type of contraceptive pills you use is not included in the list.

Did you get answers to your questions?

Please tell us how we can improve our website? Please note that we do not answer questions asked via this feature.