The risk of thromboembolic events in patients taking combined oral contraceptives and hormone replacement therapy, as well as methods of their prevention: A literature review

Currently, the risk of thromboembolic rejuvenation when taking combined oral contraceptives (COCs) and hormone replacement therapy may cause concern among both doctors and patients. The aim of the work was to analyze and summarize the available data on the use of COCs and the risk of thromboembolism. The review presents materials from domestic and foreign authors who have conducted research in women taking COCs and experiencing thrombotic complications. To write the article, 37 different sources of literature were used — articles published in the international citation databases PubMed (MEDLINE), Scopus, as well as fundamental research and monographs published in the RSCI. The data was selected according to the keywords: ”cardiovascular diseases”, ”COC”, ”PE”, ”myocardial infarction”. Materials whose authorship has not been established, textbooks, near-scientific Internet resources, as well as those that do not correspond to the research topic were excluded from the analysis. The review revealed evidence that the use of COCs may affect the risk of pulmonary embolism (PE), however, it should be borne in mind that other factors influence the formation of blood clots. Some studies show that the use of third- and fourth-generation COCs may increase the risk of PE, but this risk still remains relatively low. It is important to note that the decision on the use of COCs and the choice of a specific drug should be made by a doctor based on the individual characteristics of the patient, her medical history and risk factors. It must be remembered that quitting COCs does not guarantee a complete absence of the risk of developing PE, as it is influenced by other factors such as heredity, lifestyle, the presence of other diseases, etc.