Avoiding problems in clinical practice after the pill scare

The publications of 1995 and 1996 on the risk of venous thrombosis associat ed with the use of the combined oral contraceptive pill (COC) suggested tha t the risks were lower than previous estimates. The debate, which ensued, e nsured that the safety of the COC with regard to arterial and venous diseas e was reassessed. This review details the importance of contraception for p ublic health. It reassesses critically current prescribing practice in the light of the new publications on factor V Leiden, arterial and venous disea se. Methods of communicating information about the COC are assessed, and th e difficulties of transmitting complex scientific data to health care profe ssionals and the general public are debated. The importance of attempting t o quantify the benefits and risks of the COC and explaining them in the con text of other life events is emphasized.