Title: Coagulation and thrombosis with OC use: physiology and clinical relevance.

POPLINE Document Number: 120224

Author(s):

Comp PC

Source citation:

DIALOGUES IN CONTRACEPTION, 1996 Fall;5(1):1-3.

Abstract:

Recent studies suggesting that oral contraceptives (OCs) containing the progestins desogestrel and gestodene are associated with a two-fold increased risk of nonfatal venous thromboembolism (VTE) compared to earlier formulations have raised new issues for clinicians. The increased risk of 20-30 cases of VTE per 100,000 women annually compares with 60 VTE cases associated with pregnancy. Women with a documented history of unexplained VTE should not use OCs, and when there is a family history, physicians should weigh factors such as age of onset of thrombosis in the affected relative, the clinical setting (e.g., after surgery or trauma), and severity of the episode. The effects of OCs on procoagulants and anticoagulants are minor, except in the 5% of women with factor V Leiden mutation. A clotting assay can determine activated protein C resistance and a polymerase chain reaction test can identify the presence of this mutation; however, widespread screening of OC users is not recommended due to the low incidence of factor V Leiden and the low likelihood these women will develop clots. The present state of knowledge about OCs and VTE risk supports the application of informed clinical judgment.

Keywords:

Oral Contraceptives, Combined
Gestodene
Desogestrel
Thromboembolism
Blood Coagulation Effects
Risk Factors
Side Effects
Oral Contraceptives, Side Effects
Contraceptive Agents, Side Effects
Women
Oral Contraceptives
Contraceptive Methods
Contraception
Family Planning
Contraceptive Agents, Progestin
Contraceptive Agents, Female
Contraceptive Agents
Embolism
Vascular Diseases
Diseases
Hematological Effects
Hemic System
Physiology
Biology
Treatment
Contraceptive Safety
Safety
Public Health
Health
Demographic Factors
Population