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  • Title: 2 methods for prescribing third-generation OCs.
    Journal: Contracept Technol Update; 1997 Dec; 18(12):148-9. PubMed ID: 12348220.
    Abstract:
    John Guillebaud, medical director of the Margaret Pyke Family Planning Center in London, and Andrew Kaunitz, MD, professor and assistant chair of obstetrics and gynecology at the University of Florida Health Sciences Center in Jacksonville, make recommendations on how clinicians should prescribe desogestrel-containing oral contraceptives (OC) amid new data which indicate that the risk for venous thromboembolism (VTE) for such OCs may be lower than first reported. John Guillebaud notes that in the UK, young women with no risk factors are typically started on second-generation OCs because some of these clients may be predisposed for VTE. Patients with a VTE risk factor, such as obesity or severe varicose veins, should be taking second-generation OCs. Patients with an arterial risk factor, such as being a heavy smoker, diabetic, having lipid disorder, or high blood pressure should be encouraged to consider switching to third-generation pills as they near age 30 years. Dr. Kaunitz recommends that current users of desogestrel OCs who are doing well remain with their current OC. For clinicians who prefer to start first-time OC users on new progestin OCs and who believe that vascular disease risks may be higher with desogestrel pills, clients should be started on norgestimate-containing OCs. Other clinicians can choose to use desogestrel-containing OCs in first-time clients.
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