Combined oestrogen-progestagen contraceptives, usually taken for three weeks out of four, are effective in preventing pregnancy. The small risks of thrombosis and embolism are on the whole decreased with reduced doses of oestrogen.1 The use of the combined pill is also associated with a number of metabolic changes, including marginal impairment of carbohydrate tolerance and of liver function and an increase in some plasma lipids. Most of these metabolic changes are produced by the oestrogen component, and recent studies suggest that the progestagen is relatively inactive in this respect.2 The British Committee on Safety of Medicines and the Medical Committee of the International Planned Parenthood Federation now recommend that the combined preparations should not contain more than 50 mcg (0.05 mg) of oestrogen.
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