Show simple item record

dc.contributor.authorLidegaard, Øjvind
dc.contributor.authorMilsom, Ian
dc.contributor.authorGeirsson, Reynir Tomas
dc.contributor.authorSkjeldestad, Finn Egil
dc.date.accessioned2013-08-30T13:48:09Z
dc.date.available2013-08-30T13:48:09Z
dc.date.issued2012-07
dc.date.submitted2013-08-30
dc.identifier.citationActa Obstet Gynecol Scand 2012, 91(7):769-78en_GB
dc.identifier.issn1600-0412
dc.identifier.pmid22568831
dc.identifier.doi10.1111/j.1600-0412.2012.01444.x
dc.identifier.urihttp://hdl.handle.net/2336/300441
dc.descriptionTo access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.en_GB
dc.description.abstractNew studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published. To evaluate new epidemiological data and to propose clinical consequences. A literature survey. Studies assessing the risk of specific types of hormonal contraception were evaluated, compared and set into a clinical perspective. The majority of newer studies have demonstrated a threefold increased risk of VTE in current users of medium- and low-dose combined oral contraceptives (COCs) with norethisterone, levonorgestrel (LNG) or norgestimate compared with non-users. The same studies have demonstrated a sixfold increased risk of VTE in users of combined pills with desogestrel, gestodene, drospirenone or cyproteroneacetate, and in users of the contraceptive vaginal ring, compared with non-users. The rate ratio of VTE between users of COCs with newer progestogens compared with users of COCs with LNG was 1.5-2.8 in seven studies and 1.0 in two studies. Progestogen-only contraception did not confer an increased risk of VTE in any study. The incidence rate of VTE in non-pregnant women aged 15-49 years using non-hormonal contraception is three per 10 000 years. For women starting on hormonal contraception, we recommend medium- or low-dose combined pills with norethisterone, LNG or norgestimate as first-choice preparations. For the many women who are users of COCs with newer progestogens, although the absolute risk of VTE is low, a change to combined pills with norethisterone, LNG or norgestimate may halve their risk of VTE. Finally, we recommend COCs with 20 μg estrogen combined with the older progestogens to be launched in the Scandinavian countries. Women at an increased risk of VTE should consider progestogen-only contraception or non-hormonal contraception.
dc.description.sponsorshipBayer Pharma Denmark Organon/Schering Plough/MSD Schering/Bayer Pharma Organon/Schering Plough Pfizeren_GB
dc.language.isoenen
dc.publisherWiley-Blackwellen_GB
dc.relation.urlhttp://onlinelibrary.wiley.com/doi/10.1111/j.1600-0412.2012.01444.x/pdfen_GB
dc.rightsArchived with thanks to Acta obstetricia et gynecologica Scandinavicaen_GB
dc.subject.meshContraceptives, Oralen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIncidenceen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshVenous Thromboembolismen_GB
dc.titleHormonal contraception and venous thromboembolism.en
dc.typeArticleen
dc.contributor.departmentGynaecological Clinic 4232, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.en_GB
dc.identifier.journalActa obstetricia et gynecologica Scandinavicaen_GB
dc.rights.accessNational Consortium - Landsaðganguren
html.description.abstractNew studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published. To evaluate new epidemiological data and to propose clinical consequences. A literature survey. Studies assessing the risk of specific types of hormonal contraception were evaluated, compared and set into a clinical perspective. The majority of newer studies have demonstrated a threefold increased risk of VTE in current users of medium- and low-dose combined oral contraceptives (COCs) with norethisterone, levonorgestrel (LNG) or norgestimate compared with non-users. The same studies have demonstrated a sixfold increased risk of VTE in users of combined pills with desogestrel, gestodene, drospirenone or cyproteroneacetate, and in users of the contraceptive vaginal ring, compared with non-users. The rate ratio of VTE between users of COCs with newer progestogens compared with users of COCs with LNG was 1.5-2.8 in seven studies and 1.0 in two studies. Progestogen-only contraception did not confer an increased risk of VTE in any study. The incidence rate of VTE in non-pregnant women aged 15-49 years using non-hormonal contraception is three per 10 000 years. For women starting on hormonal contraception, we recommend medium- or low-dose combined pills with norethisterone, LNG or norgestimate as first-choice preparations. For the many women who are users of COCs with newer progestogens, although the absolute risk of VTE is low, a change to combined pills with norethisterone, LNG or norgestimate may halve their risk of VTE. Finally, we recommend COCs with 20 μg estrogen combined with the older progestogens to be launched in the Scandinavian countries. Women at an increased risk of VTE should consider progestogen-only contraception or non-hormonal contraception.


This item appears in the following Collection(s)

Show simple item record