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Oral contraception and thrombophilia
Dorit Blickstein1, Isaac Blickstein
1Hemato-Gynecology Service, Institute of Hematology, Beilinson Hospital, Rabin Medical Center, Petach-Tikva, Israel. blick@netvision.net.il
Current Opinion in Obstetrics & Gynecology
|July 13, 2007
Summary
Oral contraception use elevates thrombotic event risk, particularly in the first year. Screening for thrombophilia may reduce risks, but current testing isn't cost-effective for all users.
Area of Science:
- Pharmacology
- Hematology
- Reproductive Health
Background:
- Oral contraceptives (OCs) are widely used for birth control and managing gynecologic conditions.
- Thrombophilia, a predisposition to blood clots, significantly impacts OC safety.
- Understanding the interplay between OCs and thrombophilia is crucial for patient safety.
Purpose of the Study:
- To review current knowledge on the association between oral contraception and thrombophilias.
- To evaluate the impact of different OC generations on thrombotic risk.
- To assess the implications for screening and management of OC users with thrombophilia.
Main Methods:
- Literature review of studies investigating oral contraception and thrombophilia.
- Analysis of data on venous thromboembolism (VTE) and arterial thrombosis risks.
- Evaluation of the influence of thrombophilia on OC-related thrombotic events.
Main Results:
- Oral contraceptive use increases the risk of both venous thromboembolism and arterial thrombosis.
- Third-generation OCs may carry a higher VTE risk than second-generation OCs.
- The risk is amplified in individuals with underlying thrombophilias, especially during the first year of use.
Conclusions:
- Screening for thrombophilia in prospective OC users could potentially mitigate thrombotic event risks.
- Current diagnostic methods for thrombophilia lack cost-effectiveness and defined absolute risks.
- Physician-guided screening for thrombophilia before initiating OCs is recommended, rather than universal testing.
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