Vladimír Cupaník, Angelika Bátorová
Combined hormonal contraceptives (CHCs) increase the risk of venous thromboembolism (VTE) and arterial thromboembolic disease (ATE), including myocardial infarction and stroke. The authors discuss the possible effect s of estrogenes and particular generations of gestagens on the risk of thrombosis. VTE is considered as an undesirable side effect of CHC, but its true occurrence is rare. Contraceptives containing levonorgestrel have a lower risk compared with those containing desogestrel, gestodene, drospirenone and cyproterone acetate. New users should be properly informed about these facts. An important prerequisite for the prescription of CHC’s is the exclusion of known risk factors of VTE such as thrombosis and cardioand cerebrovascular events in personal history or in family in the first-degree relatives especially at the age ≤ 45 years, as well as seeking for hypertension, hyperlipidaemia, migraine (with aura), obesity and cigarette smoking. Keeping strict rules for the CHCs prescription, there is currently no reason to recommend for women with no risk factors, using preparations containing third-generation gestagens, drospirenone or cyproterone acetate to change these products for a different preparative.