gestodene and Cerebral-Hemorrhage

The risk of idiopathic cerebral haemorrhage in users of third-generation oral contraceptives compared with that of users of second-generation oral contraceptives was evaluated using data from the General Practice Research Database. We found no increased risk for third-generation oral contraceptives, compared with second-generation oral contraceptives.

Topics: Adult; Cerebral Hemorrhage; Contraceptives, Oral, Synthetic; Desogestrel; Female; Humans; Levonorgestrel; Middle Aged; Norpregnenes; Progesterone Congeners; Risk Factors

A 26-year-old woman suffered concomitant inferior vena cava, iliac, and femoral vein thrombosis and cerebral venous thrombosis. Ten days before symptom onset she had started using an oral contraceptive that contained low-dose ethynilestradiol and gestodene. Both protein C deficiency and protein C activated resistance were detected. To our knowledge, the association of cerebral, caval, and ilio-femoral-popliteal venous thrombosis has not been described previously. The severity of the clinical features could be a consequence of the two combined thrombophilic mechanisms and of the continuation of the oral contraceptive. A thrombophilic disorder should be considered in young patients with thromboembolic disease. Because of the high prevalence of the genetic deficiency causing protein C activated resistance, it is probably worthwhile to perform general screening before prescription of oral contraceptives.

Topics: Adult; Anticoagulants; Cerebral Hemorrhage; Cerebral Veins; Contraceptives, Oral, Hormonal; Contraceptives, Oral, Synthetic; Drug Resistance; Estradiol Congeners; Ethinyl Estradiol; Female; Femoral Vein; Follow-Up Studies; Humans; Iliac Vein; Intracranial Embolism and Thrombosis; Norpregnenes; Popliteal Vein; Prevalence; Progesterone Congeners; Protein C; Protein C Deficiency; Thrombosis; Vena Cava, Inferior; Warfarin