Thrombosis is a recognized complication of sex hormone therapy, which includes hormone replacement for deficiencies, contraceptive therapy, treatment of heavy menstrual bleeding, gender-affirming hormone therapy, suppression of ovulation, oncologic hormone therapy, and assisted reproduction. This review examines the effects of sex hormones on hemostasis and the vasculature and summarizes current evidence on thrombotic risk, including the effects of hormone formulation, thrombophilias, previous thrombosis, and common clinical factors. Practical guidance on the prevention and treatment of hormone-associated venous thromboembolism, as well as on perioperative care of patients receiving sex hormone therapy, is also provided.
“continuing hormone therapy around the time of surgery and using thromboprophylaxis, depending on the clinical scenario...The decision to continue such therapy should be based on an informed discussion of the benefits and drawbacks of doing so, as well as appropriate use of thromboprophylaxis.”
SKEITH et al. (2026) studied this question.