In the transient period that we are waiting for the full report of the independent Scientific Group Meeting on Cardiovascular Disease and Steroid Hormone Contraceptives [World Health Organization (WHO), 1997], many are anxious to present their view on the third generation oral contraceptives debate. In the overwhelming publication waves so far, different layers of debate can be distinguished, which may hamper a balanced view on the subject. The issues in the scientific debate are clear. Since 1961, the history of oral contraceptives and venous thromboembolism (VTE) has known of several acmes: involvement of a oestrogens in the development of VTE, the interaction between an inheritable coagulation disorder (Factor V Leiden) and oral contraceptive use, and the recent Unding that gestagens are also engaged in the ontogenesis of VTE. Although the last observation has been criticized some epidemiologists are carrying the criticism so far as to jeopardize the core of their own profession's knowledge the independent WHO Scientific Committee, having the disposal of all available Information, confirmed its existence as demonstrated in the four original studies (WHO, 1995, Jick et αϊ, 1995; Bloemenkamp et αϊ, Spitzer et αϊ, 1996). While a biological explanation of the phenomenon that steroids may evoke a process leading to VTE has been lacking since the early 1960s, the epidemiological findings of the 1990s have opened the way towards a beginning of a mechanistic explanation. Resistance to activated protein C (APC) as an effect of oral contraceptives, also reported in the original lest for APC resistance (0sterud et αϊ, 1994; Meinardi et αϊ, 1997; Lowe et αϊ, 1997) is an encouraging first step in our understanding. Despite the thrilling scientific progress on this matter, the finding that some gestagens carry more of an extra risk of VTE than others, leads to debates on the prescription of oral contraceptives a Situation we experienced earlier with the increased risk of VTE in women using high-dose oestrogens and more recently with carriers of Factor V Leiden (Vandenbroucke et αϊ, 1996). Some commentators are minimizing the risk of VTE in oral contraceptive users by admonishing the public that the absolute risk is negligible. Claiming that 'two times a low absolute risk of VTE remains a low absolute risk' is a reaction that does not consider the existence of highly effective alternatives for third generation pills. In younger women, VTE rather than myocardial infarcVenous thromboembolism and the pill