Few young women develop venous thromboembolism, but 2 circumstances increase risk in women of childbearing age: pregnancy, and the use of sex hormones, including oral contraceptives.
Few young women develop venous thromboembolism (VTE). However, 2 circumstances increase risk in women of childbearing age: pregnancy, and the use of sex hormones, including oral contraceptives. Health agencies in numerous countries have made efforts to warn healthcare professionals about the increased risk related to these circumstances, but it appears that prescribing patterns are very difficult to change.
A team of researchers from Germany working in concert with King's College in London, UK, has published a paper, ahead-of-print in the journal Vasa, describing the use of various types of sex hormones, and its relationship to VTE. They review the most common relationships between sex hormones and VTE, risk factors, and counseling strategies.
The most important contributing factor is the individual patient’s baseline risk for VTE. Other factors include the hormones type and dose, the application route, and specific combinations of estrogen in the product used.
This review, which is comprehensive, addresses a number of questions that clinicians often ask. The researchers make a number of points with which pharmacists should be familiar:
Sex hormones and venous thromboembolism—from contraception to hormone replacement therapy.Vasa. 2018 Jul 16:1-10. doi: 10.1024/0301-1526/a000726. [Epub ahead of print]