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Published on: February 28, 2012
Thromboembolic disease and present oral contraception
Margita Belicová1, Bohdan Lukác, Ján Dvorský
1Department of Internal Medicine, University Hospital, Martin, Slovakia. mbelicova@hotmail.com
Summary
Oral contraceptives, especially third-generation types, increase venous thrombosis risk. Women using them showed hereditary thrombophilia, highlighting the need for risk factor assessment before prescribing oral contraceptives.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Pharmacology
Background:
- Oral contraceptives (OCs) are associated with an increased risk of thromboembolic events.
- Third-generation OCs (desogestrel, gestodene, norgestimate) carry a higher risk of venous thrombosis compared to second-generation OCs (levonorgestrel).
- OC use reduces sensitivity to activated protein C, a key factor in blood clotting.
Purpose of the Study:
- To investigate the incidence of venous thromboembolism (VTE) in women using oral contraceptives.
- To identify risk factors for VTE in women on oral contraceptive therapy.
- To evaluate the role of hereditary thrombophilia in OC-associated VTE.
Main Methods:
- Retrospective analysis of 17,577 hospitalized patients from January 1996 to December 2001.
- Identification of 177 VTE cases, including 15 women on oral contraceptive therapy.
- Screening for hereditary thrombophilia after VTE diagnosis and discontinuation of oral contraceptives.
Main Results:
- 15 of 177 VTE patients (8.5%) were using oral contraceptives.
- All women on oral contraceptives with VTE had confirmed hereditary risk factors.
- Discontinuation of OCs combined with anticoagulant therapy was effective in all cases.
Conclusions:
- Acquired resistance to activated protein C may contribute to increased VTE risk in OC users.
- Third-generation OCs may pose a higher risk, particularly in women with co-existing hereditary or acquired risk factors.
- Screening for hereditary thrombophilia is crucial for women using oral contraceptives, especially those on third-generation formulations.
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