ABSTRACT
INTRODUCTION The introduction of oral contraceptives in the late 1950s has altered society and has even led to radical demographic alterations. Currently, combined oral contraceptives are the most effective and most easily reversible method of contraception. They have the best ‘pearl index’ (i.e. the number of pregnancies occurring despite the use of contraception in 100 women during 1 year).1,2 Oral contraceptives are also used for other indications, such as treatment of menstrual disorders. The widespread use of oral contraceptives has given rise to concerns about possible side effects, especially cardiovascular disease. Initial case reports on fatal thromboembolic disease in young women who used oral contraceptives have led to a multitude of studies that have assessed the risk of venous and arterial disease in relation to the use of these drugs,3-5 as well as assessing the potential underlying hemostatic and metabolic mechanisms. This chapter reviews the epidemiology of cardiovascular disease in relation to the use of oral contraceptives, as well as the presently known underlying mechanisms of cardiovascular disease in oral contraceptive users.
