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Related Experiment Videos

Estrogens, progestogens and thrombosis.

F R Rosendaal1, A Van Hylckama Vlieg, B C Tanis

  • 1Department of Clinical Epidemiology, Leiden University Medical Center, The Netherlands. f.r.rosendaal@lumc.nl

Journal of Thrombosis and Haemostasis : JTH
|July 23, 2003
PubMed
Summary

Oral contraceptives and hormone replacement therapy increase the risk of venous thrombosis, especially in the first year of use. Specific progestogens and pre-existing conditions further elevate these risks for women.

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Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Women's Health

Background:

  • Millions of women use oral contraceptives (OCs) and postmenopausal hormone replacement therapy (HRT).
  • These therapies are associated with significant cardiovascular risks, particularly venous thrombosis.
  • Understanding risk factors is crucial for patient safety.

Purpose of the Study:

  • To analyze the risks of venous and arterial cardiovascular events associated with OCs and HRT.
  • To identify specific patient and drug-related factors influencing these risks.
  • To compare risks between different generations of progestogens.

Main Methods:

  • Review of existing literature and epidemiological data on OC and HRT users.
  • Analysis of risk factors including duration of use, progestogen type, coagulation abnormalities, obesity, and prior thrombosis.

Related Experiment Videos

  • Comparison of thrombotic risk between second-generation (levonorgestrel) and third-generation (desogestrel, gestodene) progestogen-containing OCs.

    • Main Results:

    • OC use significantly increases the risk of venous thrombosis, myocardial infarction, stroke, and peripheral artery disease, with highest risks in the first year.
    • Women with coagulation abnormalities, a history of thrombosis, or obesity face a higher risk of venous thrombosis with OCs/HRT.
    • Third-generation progestogen OCs are associated with a higher risk of venous thrombosis than second-generation OCs.
    • HRT increases venous thrombosis risk and has neutral or potentially detrimental effects on arterial disease risk.
    • Prothrombotic abnormalities have a limited impact on arterial disease risk in OC and HRT users.

    Conclusions:

    • OCs and HRT pose significant thrombotic risks, particularly venous thrombosis.
    • Risk stratification is essential, considering progestogen type, duration of use, and individual patient factors.
    • Further research may be needed to fully elucidate arterial disease risks and management strategies.