Cardiovascular effects, especially thromboembolism, have been considered the leading complication of hormonal contraceptives. It appears that these effects are most often partially related to the estrogen dosage and to a lesser degree on the progestogen dosage of combined oral contraceptives (OCs). Further, certain preexisting or not yet revealed risk factors increase the likelihood of cardiovascular effects. OCs aggravate such risk factors. These contraindications include smoking, age (= or 35 years old), arterial hypertension, diabetes, and hyperlipemia. The frequency of cardiovascular complications among OC users began to fall after low-dose OCs were introduced. Thus, reducing the hormone dosage of OCs and better screening of patients are needed to further reduce the frequency of cardiovascular complications.