Norethisterone and VTE risk

Diana Mansour highlights a change in the Summary of Product Characteristics for Primolut N®, since data have emerged showing that, in high doses, norethisterone is partly metabolised to estradiol. This only applies to this particular progestogen, and only in high doses, not those used in contraceptive pills. Nevertheless, it could explain why studies have occasionally suggested an increased risk of venous thromboembolism with high-dose norethisterone, used therapeutically for the management of menorrhagia or dysfunctional uterine bleeding.

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The SDM: a realistic option for longer-term use

The Standard Days Method® (SDM), a fertility awareness-based method of family planning, is a regular part of service delivery in over 30 countries, but information about effectiveness in longer-term use is limited. Sinai et al. report on the experience of nearly 500 women who used the SDM for between 2 and 3 years. Regularity of cycle length within the range of 26–32 days was key to contraceptive effectiveness. Their study demonstrated that women whose cycle length nearly always fell within this range in the first year of use are likely to have cycles within this range thereafter. The …