Description

Since the introduction of the oral contraceptive into the United Kingdom in 1961 over 3 million women (one in three of reproductive age) have adopted the combined oral contraceptive pill (COCP) as their main form of contraception. Whilst studies show that similar numbers of peri- and post-menopausal women would benefit from hormone replacement therapy (HRT), presently, only 10-15% of the 10 million women greater than 50 years of age in the UK are on HRT. Use of the combined oral contraceptive pill is a recognised risk factor for venous thromboembolic disease (VTED). Hormone replacement therapy was, until recently, not believed to carry the same risk. Recent epidemiological studies, however, now present a consistent pattern of increased risk of VTED in users of HRT. Nonetheless, there are undisputed health benefits associated with the use of oestrogen therapy particularly as hormone replacement. In practical terms the prescribing physician and the individual woman need to evaluate the benefits of a particular therapy against the health risks in each case.