Third-generation oral contraceptives: future implications of current use

Abstract

Third-generation oral contraceptives are an association of low-dose ethinyl estradiol and potent testosterone-derived progestins, developed in order to improve general and vascular tolerance. They are highly efficient and well tolerated by most users. Their extensive use has provided different key information: oral contraceptives (as well as non-oral ethinyl estradiol-containing contraceptives) can be used in women under the age of 35 years with well-controlled metabolic risk factors and high familial risk of breast cancer. On the other hand, ethinyl-estradiol containing contraceptives are not indicated in women with a high risk of deep venous thrombosis, or noncontrolled metabolic and vascular risk factors (including being over the age of 35 years or cigarette smoking), or with a history of breast cancer. Progestin-only contraception is not well tolerated owing to bleeding. Future hormonal contraception for women with a high vascular risk may contain nontestosterone-derived progestins and 17β estradiol, ...