Venous Thromboembolism

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Venous thromboembolism (VTE) is a common disorder, and oral contraceptives (OC) are well-known risk factors associated with venous thromboembolism(VTE)^(2,15,44,49).

The individual risk of VTE varies as a result of a complex interaction between congenital and transient or permanent acquired risk factors. 

Risk factors can be either intrinsic as age, overweight, previous VTE, thrombophilia or related to surgical procedures, and/ or to medical disorders such as neoplastic diseases ^(61,62).

Inherited thrombophilia is a very important risk factor of venous thromboembolism (VTE) however, there are only few studies on the risk of VTE in women with inherited thrombophilia who use oral contraceptives ^(63,64).

Adverse Effects of Hormonal contraception Cardiovascular Effects - Myocardial Infarction - Stroke - Arterial Accidents - Venous Thromboembolism - Blood Hypertension Other Effects - Angioedema - Peliosis Hepatis - Severe Adverse Ocular Reactions - Vasculitis Moderate adverse effects Cancer Risks - Breast cancer risk - Ovarian cancer risk - Endometrial cancer risk - Cervical cancer risk - Colorectal cancer risk - Skin cancer risk - Liver cancer risk - Pancreatic cancer risk - Neurofibromas growth - Unclear cancer risks Hazardous prescription Hormonal contraception in female transplant recipients - Hormonal contraception in female kidney recipients - Hormonal contraception in female liver transplant recipients - Hormonal contraception in female heart transplant recipients - Contraception in women HIV infected Mild Adverse effects New Perspectives immunocontraception Contraceptive counseling Conclusion

Retrospective family cohort studies revealed the absolute risk of venous thromboembolism in women with single or multiple thrombophilic defects taking hormonal contraceptives ^(64,65,66).

Because of the high prevalence of the carriers of the G20E10A mutation of the prothrombin gene (PT20210A) (6.5%) and the carriers of the factor V Leiden mutation (FVL) (2%) (a hereditary disorder in which activated factor V is inactivated by activated protein C) in the Spanish population, a retrospective family cohort study of 325 women, belonging to 97 families with inherited thrombophilia, was performed to determine the risk of VTE associated with hormonal contraceptives (HCs) intake.

The results of this study showed for carriers of the PT20210A mutation, the risk of VTE in HC users was 3-fold higher than that in non-carriers.

Carriers of FVL (FactorV Leiden) mutation taking HCs showed an OR of 1.4, indicating a tendency to increase the risk of VTE ⁽⁶⁷⁾.

Genetic screening for these mutations should be considered in potential OC users belonging to families with thrombophilia ⁽⁶⁸⁾. Women with hereditary deficiencies of protein S, protein C or antithrombin are at high risk of VTE when taking hormonal contraceptives, particularly if other thrombophilic defects are present ^(69,70,71).

Generally, they have VTE at a younger age, and sometimes this event may be dramatic but the overall risk is not increased by HCs ^{(72,73,74,75)}.

In addition, rare cases of thromboembolism in young women caused from the increase of coagulation factor VIII were reported ^(76,77).

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Contraceptive counseling   Progesterone Receptor Modulators (PMRS) and Progesterone Antagonists (PAS)   Conclusion - adverse effects of Hormonal contraception   New Perspectives immunocontraception   Low Libido as adverse effect of Hormonal contraception   Vaginal Infections as adverse effect of Hormonal contraception   Depression as adverse effect of Hormonal contraception   Ovarian cysts as adverse effect of Hormonal contraception   Irregular Bleeding Pattern as adverse effect of Hormonal contraception   Mild Adverse effects of Hormonal contraception   Dermatological Adverse effects   Headache as Adverse Effect of Hormonal contraception   Adverse effects on carbohydrate and lipid metabolism   Moderate adverse effects hepatobiliary complications   Hormonal contraception in female heart transplant recipients

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