Women who developed thromboembolic events while taking oral contraceptives or HT had high prevalence of thrombophilia

DeSancho MT. Blood Coagul Fibrinolysis. 2010;21:534-538.

There was a high prevalence of thrombophilia in women taking oral contraceptives or hormone therapy, often occurring after the first year of use, according to the findings of a recent study.

Researchers retrospectively examined data of 65 women who developed a thromboembolism while using oral contraceptives or HT and who had at least one additional thrombophilia risk factor.

Twenty-three women had more than two thrombophilias, 16 had Factor V Leiden, five had the prothrombin gene G20210A polymorphism, 26 had antiphospholipid antibodies, 10 had increased homocysteine, four had protein C deficiency and seven had protein S deficiency.

There were 64 thromboembolic events, including 16 pulmonary emboli, 17 cerebrovascular events, 11 intra-abdominal thromboses, 13 deep vein thromboses, five cases of superficial thrombophlebitis and two retinal vein thromboses.

Forty-nine percent of women who used oral contraceptives and 72% of women who used HT had done so for more than a year.

Thirty-seven percent of women had a positive family history of thrombosis.

For women considering oral contraceptives or HT, until broader recommendations are accepted, the current standard of care should include a careful history of personal risk factors for thrombosis and a personal and familial history of vascular thrombosis, according to the researchers.

“Women who have venous or arterial thromboembolic events while taking oral contraceptives or [HT] have a high likelihood of having thrombophilia,” they wrote. “It is therefore appropriate to test for thrombophilia if such testing would impact future treatment, specifically if testing would guide women in minimizing additional risk for thromboses.”

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