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Cited by 213Blood Coagulation and Thrombosis MechanismsVenous Thromboembolism Diagnosis and ManagementPlatelet Disorders and Treatments

Higher risk of venous thrombosis during early use of oral contraceptives in women with inherited clotting defects

Bloemenkamp, Kitty W. M., Rosendaal, Frits R., Helmerhorst, Frans M., Vandenbroucke, Jan P.·2000·Archives of Internal Medicine
DOI 10.1001/archinte.160.1.49
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Abstract

BACKGROUND: Results of recent studies show that the risk for venous thrombosis is highest during initial oral contraceptive use. This suggests a subgroup of females who are at immediate risk of thrombosis when exposed to oral contraceptives. OBJECTIVE: To determine whether women with inherited clotting defects who use oral contraceptives develop venous thrombosis at an earlier stage than do those without inherited clotting defects. METHODS: Analysis of the data from the Leiden Thrombophilia Study, a population-based case-control study with data on duration of oral contraceptive use and recently detected genetic coagulation disorders. Patients had a first episode of objectively proven deep vein thrombosis. Patients and controls were considered thrombophilic when they had protein C deficiency, protein S deficiency, antithrombin deficiency, factor V Leiden mutation, or prothrombin 20210 A mutation. RESULTS: Risk of developing deep vein thrombosis was greatest in the first 6 months and the first year of oral contraceptive use. Compared with prolonged use, the risk of developing deep vein thrombosis was 3-fold higher in the first 6 months of use (95% confidence interval [CI], 0.6-14.8) and 2-fold higher in the first year of use (95% CI, 0.6-6.1). Patients who developed venous thrombosis in the early periods of use were more often thrombophilic. Among women with thrombophilia, the risk of developing deep vein thrombosis during the first 6 months of oral contraceptive use (compared with prolonged use) was increased 19-fold (95% CI, 1.9-175.7), and in the first year of use, it was increased 11-fold (95% CI, 2.1-57.3). CONCLUSIONS: Women with inherited clotting defects who use oral contraceptives develop venous thrombosis not only more often but also sooner than do those without inherited clotting defects. Venous thrombosis in the first period of oral contraceptive use might indicate the presence of an inherited clotting defect.

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  • The most common clinical presentation of estrogen-related thrombosis is venous thromboembolism of the deep veins of the legs or pulmonary vessels, usually within the first few months of use.

    “The most common clinical presentation of estrogen-related thrombosis is venous thromboembolism (VTE) of the deep veins of the legs or pulmonary vessels, usually within the first few months of use.”

    From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [101]

  • Data from the population-based case-control Leiden Thrombophilia Study showed that the risk of developing VTE was greatest in the first 6 months of CHC use.

    “Data from the population-based case-control Leiden Thrombophilia Study showed that the risk of developing VTE was greatest in the first 6 months of CHC use.”

    From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [101]

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Authors
Bloemenkamp, K. W. M., Rosendaal, F. R., Helmerhorst, F. M., & Vandenbroucke, J. P.
Affiliations
Leiden University Medical Center (NL)
ORCID
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2000-01-10
Volume
160
Issue
1
Pages
49
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.160.1.49
OpenAlex
W2163417915
Cited by
213
References
27
Citations by year
2026: 1 · 2025: 4 · 2024: 9 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 10 · 2016: 8 · 2015: 6 · 2014: 5 · 2013: 6 · 2012: 5
FWCI
9.23
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
  • Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
  • Health Sciences › Medicine › Hematology › Platelet Disorders and Treatments
Keywords
venous thrombosis, deep vein thrombosis, oral contraceptives, thrombophilia, duration of contraceptive use, protein C deficiency, protein S deficiency, antithrombin deficiency, factor V Leiden, prothrombin G20210A
MeSH terms
Adolescent, Adult, Blood Coagulation Disorders, Contraceptives, Oral, Female, Humans, Middle Aged, Risk, Risk Factors, Time Factors, Case-Control Studies, Venous Thrombosis

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