Hormone therapy and thromboembolic disease.

摘要: Purpose of reviewHormone therapy increases the risk venousthromboembolism (VTE). To reduce this risk, changes indosage, composition and route administration have beenmade over years. This review provides a summary theavailable evidence an update on most recentfindings issue.Recent findingsContraceptives containing third-generationprogestagens confer higher VTE thansecond-generation compounds. Little data are available onpreparations less than 30mg estrogen,new progestagens or levonorgestrel-releasing intrauterinedevices.HormonereplacementtherapyincreasestheriskofVTE by 2 to 3-fold. Transdermal may be lessthrombogenic oral administration, while differentestrogens carry different risk.VTE is further increased in carriers inheritedthrombophilia. Despite similar increase relative ofthrombosis associated with hormone therapy, absolute riskis lower fertile women postmenopausalones. Universal screening for thrombophilia beforeprescribing replacement might becost-effective.SummaryCareful evaluation individual factor warrantedbefore prescribing therapy. Further investigationsare needed establish whether not newer compoundsare safer older ones respect ofthrombosis.Keywordshormone contraceptives,thrombophilia, venous thrombosis