Hormonal contraception and venous thromboembolism

Acta Obstetricia Et Gynecologica Scandinavica
O LidegaardFinn Egil Skjeldestad

Abstract

New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published. To evaluate new epidemiological data and to propose clinical consequences. A literature survey. Studies assessing the risk of specific types of hormonal contraception were evaluated, compared and set into a clinical perspective. The majority of newer studies have demonstrated a threefold increased risk of VTE in current users of medium- and low-dose combined oral contraceptives (COCs) with norethisterone, levonorgestrel (LNG) or norgestimate compared with non-users. The same studies have demonstrated a sixfold increased risk of VTE in users of combined pills with desogestrel, gestodene, drospirenone or cyproteroneacetate, and in users of the contraceptive vaginal ring, compared with non-users. The rate ratio of VTE between users of COCs with newer progestogens compared with users of COCs with LNG was 1.5-2.8 in seven studies and 1.0 in two studies. Progestogen-only contraception did not confer an increased risk of VTE in any study. The incidence rate of VTE in non-pregnant women aged 15-49 years using non-hormonal contraception is three per 10 000 years. For women starting on hormonal contraception, we reco...Continue Reading

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