What is the clinical evidence from this study?

Study design: Review. Population: Venous thromboembolism (VTE). Intervention: Oral Contraceptives and Hormone Replacement Therapy vs. Non-users. Primary outcome: Risk of venous thromboembolism.

January 4, 2017

Oral Contraceptives and HRT Risk of Thrombosis

Key Result

Estrogen-containing oral contraceptives and hormone replacement therapy increase the risk of venous thromboembolism, with the risk being dose-dependent and exacerbated by age and thrombophilia.

Structured PICO

Does estrogen-containing medication (oral contraceptives and HRT) increase the risk of venous thromboembolism in women?

Population

Women of reproductive and postmenopausal age using estrogen-containing medications for contraception or hormone replacement therapy.

Exposure

Estrogen-containing medications (oral contraceptives and hormone replacement therapy)

Comparator

Non-users, or different formulations, doses, and routes of administration

Outcome

Venous thromboembolic complications (VTE, DVT, PE)safety

Estrogen-containing oral contraceptives and hormone replacement therapy increase the risk of venous thromboembolism, necessitating careful risk stratification, especially in women with underlying thrombophilia.

Limitations

Review article summarizing multiple studies with varying methodologies
Lack of large randomized trials for some specific formulations and rare conditions

Abstract

Estrogen-containing medication, prescribed either for contraception in women of reproductive age or for prevention of cardiovascular events and osteoporosis as well as for alleviation of symptoms related to menopause, is associated with changes in the hemostatic balance and contributes to increased risk of development of venous thromboembolic complications. This risk is dose and medication dependent, increases with age, congenital and/or acquired predisposition to thrombosis, and mode of administration. This review attempts to summarize the current knowledge regarding the pathophysiology of oral contraceptive (OC) and hormone replacement therapy (HRT) -induced prothrombotic state in women, the risk of thrombosis associated with administration of various commercially available OCs and HRT, the additional risk in women with hereditary or acquired thrombophilia, and the currently available recommendations regarding massive screening of women for thrombophilia prior to initial prescription or continuation of treatment with OCs and HRT preparations.

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Cite This Study

Gialeraki et al. (Wed,) conducted a review in Venous thromboembolism (VTE). Oral Contraceptives and Hormone Replacement Therapy vs. Non-users was evaluated on Risk of venous thromboembolism. Estrogen-containing oral contraceptives and hormone replacement therapy increase the risk of venous thromboembolism, with the risk being dose-dependent and exacerbated by age and thrombophilia.

synapsesocial.com/papers/6a3472f1fffc880e77ac4bf0 https://doi.org/https://doi.org/10.1177/1076029616683802

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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