Blanco-Molina Angeles, Monreal Manuel
Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain.
Expert Rev Cardiovasc Ther. 2010 Feb;8(2):211-5. doi: 10.1586/erc.09.175.
Hormonal contraceptives are a popular method of contraception, but their use has been associated with an increased risk for venous thromboembolism. In order to reduce such risk, these compounds have been changed in their dosage, chemical composition and route of administration. The absolute risk of death from pulmonary embolism in contraceptive users has been estimated to be 10.5 (95% CI: 6.2-16.6) per million woman-years. The safest option is an oral contraceptive containing levonorgestrel combined with a low dose of estrogen. Identifying women at increased risk for venous thromboembolism is difficult, and greater use of thromboprophylaxis during immobility or minor surgery should be warranted. Several authors have called for all women to be screened for thrombophilia before prescription of hormonal contraceptives, but its cost-effectiveness remains uncertain.
激素避孕药是一种常用的避孕方法，但其使用与静脉血栓栓塞风险增加有关。为了降低此类风险，这些化合物在剂量、化学成分和给药途径方面都已有所改变。据估计，避孕药使用者因肺栓塞死亡的绝对风险为每百万妇女年10.5例（95%置信区间：6.2 - 16.6）。最安全的选择是含有左炔诺孕酮与低剂量雌激素的口服避孕药。识别静脉血栓栓塞风险增加的女性很困难，因此在女性活动不便或进行小手术期间，更应加强血栓预防措施。几位作者呼吁在开具激素避孕药处方前对所有女性进行血栓形成倾向筛查，但其成本效益仍不确定。
