Which combined oral contraceptive pill formulation poses the LOWEST risk of venous thromboembolism?
- A Ethinyl oestradiol + desogestrel
- B Ethinyl oestradiol + gestodene
- C Ethinyl oestradiol + levonorgestrel ✓
- D Ethinyl oestradiol + drospirenone
Correct answer: C. Ethinyl oestradiol + levonorgestrel
Explanation
The VTE risk of combined OCPs is primarily determined by the progestogen component. Second-generation progestogens, particularly levonorgestrel, carry the lowest VTE risk among combined pills because they have partial androgenic activity that counteracts oestrogen-induced increases in clotting factors. Third-generation progestogens (desogestrel, gestodene) and newer agents (drospirenone, cyproterone) have 2-3 fold higher VTE risk compared to levonorgestrel-containing preparations.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.