Plunkett E R
Am J Obstet Gynecol. 1982 Mar 15;142(6 Pt 2):747-51. doi: 10.1016/s0002-9378(16)32482-6.
There is evidence that women who use oral contraceptives may be at slightly greater risk of cardiovascular complications as their age increased beyond 35 years. Popular opinion has held that these risks were largely estrogen-related. At the same time, however, postmenopausal women taking natural estrogen alone or in association with minimal amounts of progestogen have not exhibited these increased risk when compared with untreated control subjects. New clinical data indicate that there is a progestogen dose-related decrease in high-density lipoprotein cholesterol. There is also some evidence that relates progestogen dosage to morbidity rates from circulatory disease. Therefore the smallest dose of both estrogen and progestogen consistent with contraceptive efficacy and reasonable cycle control must be sought for all steroid combinations. This applies particularly to oral contraception for the woman beyond 35 years of age.
有证据表明，使用口服避孕药的女性在年龄超过35岁后，患心血管并发症的风险可能会略高。普遍观点认为，这些风险主要与雌激素有关。然而，与此同时，与未接受治疗的对照受试者相比，单独服用天然雌激素或与少量孕激素联合服用的绝经后女性并未表现出这些增加的风险。新的临床数据表明，高密度脂蛋白胆固醇会随着孕激素剂量的增加而降低。也有一些证据将孕激素剂量与循环系统疾病的发病率联系起来。因此，对于所有类固醇组合，必须寻求与避孕效果和合理的周期控制相一致的最小雌激素和孕激素剂量。这尤其适用于35岁以上女性的口服避孕。
