Hormones and pregnancy: thromboembolic risks for women
Open Access
- 9 July 2004
- journal article
- review article
- Published by Wiley in British Journal of Haematology
- Vol. 126 (4), 443-454
- https://doi.org/10.1111/j.1365-2141.2004.05041.x
Abstract
During their lifetimes, women face several unique situations with an increased risk of venous thromboembolism (VTE). Doctors in a variety of specialties must advise women on the risks of oral contraceptives (OC), hormone replacement or pregnancy. Modern 'low dose' OC are associated with a three to sixfold increased relative risk of VTE. Hormone replacement and selective oestrogen receptor modulators confer a similar two to fourfold increase in thrombotic risk. However, because the baseline incidence of thrombosis is higher in older postmenopausal women, the absolute risk is higher than in younger OC users. The risk of venous thrombosis is six to 10-fold higher during pregnancy than in non-pregnant women of similar age. Thrombophilic disorders increase the thrombotic risk of OC, hormone replacement and pregnancy, especially in women with homozygous or combined defects. This review focuses on recent data estimating the thrombotic risk of hormonal therapies and pregnancy in women with and without other thrombotic risk factors.Keywords
This publication has 122 references indexed in Scilit:
- Effects of Conjugated Equine Estrogen in Postmenopausal Women With HysterectomyJAMA, 2004
- Inherited and Acquired Risk Factors for Venous Thromboembolic Disease Among Women Taking Tamoxifen to Prevent Breast CancerJournal of Clinical Oncology, 2003
- Effect of Oral and Transdermal Estrogen Replacement Therapy on Hemostatic Variables Associated With Venous ThrombosisArteriosclerosis, Thrombosis, and Vascular Biology, 2003
- Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women's Health Initiative Randomized Controlled TrialJAMA, 2002
- Randomized Trial of Estrogen Plus Progestin for Secondary Prevention of Coronary Heart Disease in Postmenopausal WomenJAMA, 1998
- Tamoxifen and risk of idiopathic venous thromboembolismBritish Journal of Clinical Pharmacology, 1998
- Risk of venous thromboembolism in users of hormone replacement therapyThe Lancet, 1996
- Risk of idiopathic cardiovascular death and rionfatal venous thromboembolism in women using oral contraceptives with differing progestagen componentsThe Lancet, 1995
- A Randomized Clinical Trial Evaluating Tamoxifen in the Treatment of Patients with Node-Negative Breast Cancer Who Have Estrogen-Receptor–Positive TumorsNew England Journal of Medicine, 1989
- PULMONARY EMBOLISMThe Lancet, 1961