Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2014) 35 S15.3 | DOI: 10.1530/endoabs.35.S15.3

ECE2014 Symposia Thromboembolism and contraception (3 abstracts)

The view of the gynecologist on thromboemboembolism

Øjvind Lidegaard


Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.


Aim: Individual compliance, thrombotic risks, and relief of menstrual complains are the three main components determining hormonal contraceptive choices. The aim of this survey was to see how these terms influences choices in different age groups.

Material and methods: Literature survey.

Results: Women generally comply well with different types of hormonal contraceptives. A minority may have trouble taking one tablet a day, and others can be mood sensitive to certain progestogens.

The baseline risk of venous thrombosis increases seven times from about 1/10 000 per year at 15 years to 7/10 000 years at 49 years. Combined hormonal contraceptives increases the risk of venous thrombosis three to seven times as compared with non-users, and products with newer progestogens (desogestrel, gestodene, or drospirenone) imply about the doubled risk as compared with products with older progestogens (levonorgestrel, norethisterone, or norgestimate). Among women using high risk products for 10 years from age 30 years, more than 1% will develop a venous thrombosis. Among genetically predisposed even more. Vaginal ring and transdermal contraceptive patches belong to high risk products, while progestogen-only products do not increase the risk of venous thrombosis.

Menstrual regularity and relief of menstrual complains are wishes among many women in all ages, and combined products with all types of progestogens are generally effective in this respect.

Conclusion: Low risk combined products should be first choice in young women, while progestogen-only products including levonorgestrel intrauterine system become increasingly relevant with increasing age and with further risk factors of venous thrombosis. High risk combined products should only be used exceptionally to women who are not able to comply with low or no risk products.

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