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Hormonal contraception and thrombosis.

Regine Sitruk-Ware1

  • 1Population Council, Center for Biomedical Research, New York, New York.

Fertility and Sterility
|September 29, 2016
PubMed
Summary
This summary is machine-generated.

Combined hormonal contraceptives (CHCs) are safe for preventing pregnancy, with a low risk of venous thromboembolism (VTE) in young users. Newer formulations may offer an improved safety profile by minimizing metabolic changes.

Keywords:
Estrogenhormonal contraceptionprogestinrisk factorsvenous thromboembolism

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Area of Science:

  • Reproductive Health
  • Pharmacology
  • Thrombosis Research

Background:

  • Combined hormonal contraceptives (CHCs) are widely used for pregnancy prevention.
  • Venous thromboembolism (VTE) is a rare but serious risk associated with CHCs.
  • Existing studies show conflicting results regarding VTE risk among different CHC formulations.

Purpose of the Study:

  • To evaluate the safety profile of combined hormonal contraceptives (CHCs).
  • To compare the risks and benefits of CHCs against pregnancy.
  • To explore how modifications in CHC composition affect VTE risk.

Main Methods:

  • Review of epidemiological studies and clinical outcome data.
  • Analysis of the impact of different estrogen types (Ethinyl-estradiol vs. Estradiol) and progestins on metabolic and coagulation markers.
  • Consideration of study design differences and adjustment for risk factors like smoking and obesity.

Main Results:

  • The overall benefit-risk balance of CHCs is generally favorable compared to pregnancy.
  • VTE risk associated with CHCs is rare in young populations.
  • Estradiol (E2)-based CHCs may have an improved safety profile due to lower metabolic impact compared to Ethinyl-estradiol (EE)-based formulations.

Conclusions:

  • CHCs are a safe and effective contraceptive option.
  • The risk of VTE with CHCs is low, especially with careful consideration of individual risk factors.
  • Formulation modifications, including the use of E2 and newer progestins, aim to enhance CHC safety.