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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. from Anne Szarewski, Editor in Chief, JFPRHC