雌激素,孕激素,以及其他:血栓形成风险和避孕选择
Leslie Skeith1, Shannon M Bates2
1Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Alberta, Canada.
Hematology. American Society of Hematology. Education Program
|December 7, 2024
概括
荷尔蒙避孕药在静脉血栓栓塞 (VTE) 风险方面有所不同. 组合激素避孕药 (CHC) 和一些仅含孕激素的方法会增加静脉突发症的风险,而其他方法则不会,需要对患者进行仔细的咨询.
科学领域:
- 生殖健康 生殖健康
- 血栓形成研究研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 激素避孕药治疗涉及雌激素和孕激素,配方与各种静脉血栓栓塞 (VTE) 风险有关.
- 组合激素避孕药 (CHC) 的血栓发生性源于凝血因子和血管系统的改变,受雌激素剂量和孕激素类型的影响.
研究的目的:
- 在不同的药物和临床情景中审查与避孕药相关的VTE风险.
- 在患有遗传性血栓性病,全身性红斑狼和状细胞病的患者中检查VTE风险.
- 讨论相关的临床实践指南以及多学科患者咨询的必要性.
主要方法:
- 审查关于激素避孕药和VTE的现有文献.
- 分析与各种避孕配方 (CHC,仅含孕激素的药物) 相关的VTE风险.
- 考虑患有血栓形成风险增加的特定患者群体.
主要成果:
- 通过皮肤贴片和阴道环配方与口服避孕药相比,表现出类似或更高的VTE风险.
- 德波特甲基酸可能会增加VTE风险;基于levonorgestrel的IUD和低剂量仅含孕激素的药丸不会增加VTE风险.
- 对于仅含孕激素的皮下植入物,关于VTE风险的数据有限.
结论:
- 避孕的选择显著影响VTE风险,需要个性化评估.
- 在选择荷尔蒙避孕药时,特定的患者群体需要仔细考虑VTE风险.
- 通过多学科咨询以患者为中心的决策对于安全的避孕使用至关重要.
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