Risk of Venous Thromboembolic Disease Associated With Hormonal Contraceptives and Hormone Replacement Therapy: A Clinical Review
Abstract
Venous thromboembolic events (VTEs) represent a serious complication related to hormonal contraception and hormone replacement therapy (HRT). Evidence on hormonal contraceptive– and HRT-related VTEs is derived almost exclusively from observational studies and points to a 2- to 6-fold increased relative risk of VTEs with either therapy. Oral contraceptive pills that contain third-generation progestins (desogestrel or gestodene) seem to be associated with greater VTE risk than those that contain levonorgestrel. Oral contraceptivepilluseandHRTareassociatedwithexponentiallyhigherVTErelativeriskswhenusedbywomen who carry an inherited hypercoagulable state. The indication of a lower or a lack of VTE risk associated with the use of progestin-only contraceptives and with transdermal HRT suggests that these therapies may be safer than combination oral contraceptive pills and oral HRT for women in whom
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In patients with thrombosis provoked by hormonal contraception, the risk of recurrence returns to baseline within one to three months of cessation of hormonal use.
“In patients with thrombosis provoked by hormonal contraception, the risk is believed to return to baseline levels within one to three months of cessation of hormonal use [100, 107].”
From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [107]
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References 124 · Cited by 44
- Authors
- Gomes, M. P. V., & Deitcher, S. R.
- Affiliations
- Cleveland Clinic (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2004-10-11
- Volume
- 164
- Issue
- 18
- Pages
- 1965
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1591823274
- Cited by
- 44
- References
- 124
- Citations by year
- 2021: 1 · 2013: 2 · 2012: 1
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- Topics
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- venous thromboembolism, hormonal contraception, hormone replacement therapy, oral contraceptives, progestins, desogestrel, gestodene, levonorgestrel, progestin-only contraceptives, transdermal estrogen, thrombosis risk
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