Anticonception and risk of thrombosis

The risk of developing thrombosis in women of the childbearing age is generally below 1: 1000, making it a rare and unusual event. In recent years, deadly thrombosis and pulmonary embolism have been reported in increasing numbers in the context of the contraceptive pill. Among different micro pills in use there is a generally increased but unequal risk for vascular occlusive complications.

Ahead of planning anticonception it is a necessary commitment to assess the individual thrombotic risk profile in every woman to avoid serious errors in the decision of the contraceptive methods. A history of previous thrombosis is a misconception for the use of any estrogen-containing contraceptives and the concomitant use of an anticoagulant drug following thrombosis does not abrogate this misconception.

Depending on the individual risk-profile, women at increased risk for thrombosis still have the opportunity for oral or local hormonal contraception. A special feature is that thrombosis among pill users often manifests at unusual sites in the body such as in the upper extremities or in the brain (sinus vein thrombosis). In women with a family history - especially in 1st degree relatives - for thrombosis / pulmonary embolism or vascular occlusive events that have occurred at a young age (<50 years) such as heart attack or stroke, clarification of the individual risk of thrombosis is strongly recommended to adapt the kind an method of contraception accordingly.

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