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[Estrogen therapy and venous thromboembolic disease]
1Département de médecine interne, CHU Rouen-Boisguillaume, France.
La Revue De Medecine Interne
|January 1, 1997
Summary
Third-generation oral contraceptives and postmenopausal hormone therapy increase venous thromboembolism risk. This risk, while elevated, remains small compared to potential cardiovascular benefits.
Area of Science:
- Pharmacology
- Epidemiology
- Thrombosis
Context:
- Established link between oral contraceptives (OCs) and venous thromboembolism (VTE).
- Need to analyze recent epidemiological data on VTE risk with OCs and hormone replacement therapy (HRT).
Purpose:
- To analyze recent epidemiological studies on VTE risk associated with oral contraceptive use and postmenopausal hormone replacement therapy.
- To compare VTE risk between different generations of progestins in oral contraceptives.
Summary:
- Four studies indicate a two-fold increase in VTE risk with third-generation progestin-containing OCs (gestodene, desogestrel) compared to second-generation (levonorgestrel).
- Third-generation OCs induce activated protein C resistance, similar in magnitude to Factor V Leiden mutation.
- Postmenopausal HRT (estrogen-only or combined) also shows a two-fold VTE risk increase.
Impact:
- Highlights increased VTE risk with specific oral contraceptives and hormone replacement therapies.
- Provides comparative risk data for different progestin generations.
- Emphasizes that VTE risk is small relative to other therapeutic benefits.