February 1, 2002Open Access
View Full PaperFemale Hormones and Thrombosis
Key Result
Exogenous hormones, including oral contraceptives and hormone replacement therapy, increase the risk of venous thrombosis, myocardial infarction, and stroke, especially in the first year of use.
Structured PICO
Do exogenous hormones increase the risk of venous thrombosis, myocardial infarction, and stroke in women?
P
Population
Women using exogenous hormones (oral contraceptives or postmenopausal hormone replacement)
E
Exposure
Exogenous hormones (oral contraceptives, including third-generation containing desogestrel or gestodene, and postmenopausal hormone replacement therapy)
O
Outcome
Venous thrombosis, myocardial infarction, and strokehard clinical
Exogenous hormones, including oral contraceptives and hormone replacement therapy, increase the risk of venous thrombosis and cardiovascular events, particularly in the first year of use and in women with underlying coagulation abnormalities.
Abstract
Exogenous hormones are used by more than a hundred million women worldwide as oral contraceptives or for postmenopausal hormone replacement. Oral contraceptives increase the risk of venous thrombosis, of myocardial infarction, and of stroke. The risk is highest during the first year of use. The venous thrombotic risk of oral contraceptives is high among women with coagulation abnormalities and with so-called third-generation contraceptives (containing desogestrel or gestodene). The risk of myocardial infarction does not appear to depend on coagulation abnormalities or the type of oral contraceptive. Hormone replacement therapy increases the risk of venous thrombosis. This risk is also highest in the first year of use and among women with coagulation abnormalities. The risk becomes very high in women with a previous venous thrombosis. Randomized trials have not confirmed a beneficial effect of postmenopausal hormones on the occurrence of myocardial infarction.