A. Risks
The risk of cardiovascular disease among women attri¬buted to the use of oral contraceptives became immediately apparent following the use of these agents more than 40 years ago. The risk was alarming in women older than age 30 who smoked cigarettes. The use of third generation oral contraceptives is purported to have a lower risk of myocardial infarction compared with second generation oral contraceptives. Recent studies do not indicate that third generation contraceptives possess a lower risk for infarction and most important, the studies indicate a significantly increased risk for deep vein thrombosis (DVT) and pulmonary embolism compared with users of second generation contraceptives. Because the risk for myocardial infarction in women before age 35 is extremely low, studies are confounded.
The risk of heart attack has not been minimized by the use of third generation oral contraceptives. Cigarette smoking continues to be the major factor for increased risk of heart attacks in older, childbearing women aged 33–45 and second or third generation contraceptives increase that risk. Most important, the increased risk for DVT and thromboembolism has not been removed.
1. Increased Coagulation Factors

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