Hormonal therapies and venous thrombosis: Considerations for prevention and management.
Hormonal therapies and venous thrombosis: Considerations for prevention and management.
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DOI：
10.1002/rth2.12763
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发表时间：
2022-08
影响因子：
4.6
通讯作者：
DeLoughery, Thomas G.
中科院分区：
文献类型：
--
作者：
LaVasseur, Corinne;Neukam, Suvi;Kartika, Thomas;Bannow, Bethany Samuelson;Shatzel, Joseph;DeLoughery, Thomas G.
静脉血栓形成是激素治疗的公认并发症。激素避孕药以及针对更年期和性别转变的激素替代疗法均存在血栓形成风险。在过去的几十年里，大型流行病学研究有助于更好地确定这些风险。回顾和讨论许多可用激素制剂的血栓形成风险差异以及它们与患者特定因素的相互作用。我们对有关静脉血栓形成和激素疗法（包括避孕、更年期症状和性别转变）的现有文献进行了叙述性回顾。含雌激素化合物的血栓形成风险随着雌激素全身剂量的增加而增加。虽然仅含黄体酮的产品与血栓形成无关，但当与复方口服避孕药中的雌激素搭配使用时，黄体酮的配方确实会影响风险。这些成分以及患者特定因素可能会影响激素制剂的选择。对于接受激素治疗而发生血栓的患者，抗凝治疗可以预防未来的血栓形成。抗凝治疗的持续时间取决于当前和未来激素治疗的选择。最后，对于被诊断患有 COVID-19 等血栓性疾病的个体，激素治疗的最佳管理仍不清楚。在考虑激素避孕或激素替代疗法时，临床医生必须考虑多种因素，包括激素类型、剂量、途径、血栓形成的个人和家族史以及其他血栓前危险因素，以便就静脉血栓形成的风险做出明智的、个性化的决定。
Venous thromboses are well‐established complications of hormonal therapy. Thrombosis risk is seen with both hormonal contraceptive agents and with hormone replacement therapy for menopause and gender transition. Over the past several decades, large epidemiological studies have helped better define these risks. To review and discuss the differences in thrombosis risk of the many of hormonal preparations available as well as their interaction with patient‐specific factors. We conducted a narrative review of the available literature regarding venous thrombosis and hormonal therapies including for contraception, menopausal symptoms, and gender transition. Thrombosis risk with estrogen‐containing compounds increases with increasing systemic dose of estrogen. While progesterone‐only–containing products are not associated with thrombosis, when paired with estrogen in combined oral contraceptives, the formulation of progesterone does impact the risk. These components, along with patient‐specific factors, may influence the choice of hormonal preparation. For patients who develop thrombosis on hormonal treatment, anticoagulation is protective against future thrombosis. Duration of anticoagulation is dependent on ongoing and future hormone therapy choice. Finally, the optimal management of hormone therapy for individuals diagnosed with prothrombotic illnesses such as COVID‐19 remains unclear. When contemplating hormonal contraception or hormone replacement therapy, clinicians must consider a variety of factors including hormone type, dose, route, personal and family history of thrombosis, and other prothrombotic risk factors to make informed, personalized decisions regarding the risk of venous thrombosis.
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DOI：
10.1097/gme.0000000000000956
发表时间：
2018-01
期刊：
Menopause (New York, N.Y.)
影响因子：
--
作者：
Crandall CJ;Hovey KM;Andrews CA;Chlebowski RT;Stefanick ML;Lane DS;Shifren J;Chen C;Kaunitz AM;Cauley JA;Manson JE
通讯作者：
Manson JE
影响因子：
14.6
作者：
Bird, Steven T.;Hartzema, Abraham G.;Delaney, Joseph A. C.
通讯作者：
Delaney, Joseph A. C.
影响因子：
5.8
作者：
Bhasin, Shalender;Cunningham, Glenn R.;Montori, Victor M.
通讯作者：
Montori, Victor M.
影响因子：
168.9
作者：
Farmer, RDT;Lawrenson, RA;Hambleton, IR
通讯作者：
Hambleton, IR
影响因子：
2.9
作者：
Dinger, Juergen;Thai Do Minh;Heinemann, Klaas
通讯作者：
Heinemann, Klaas