Hugon-Rodin Justine, Blondon Marc, Bénard Julie, Plu-Bureau Geneviève, Streuli Isabelle
Unité de médecine de la reproduction et d'endocrinologie gynécologique, HUG et Faculté de médecine, 1211 Genève 14.
Unité de gynécologie endocrinienne, Hôpital Port-Royal, Université Paris Descartes, 75014 Paris, France.
Rev Med Suisse. 2017 Oct 25;13(580):1821-1825.
Venous thromboembolism is frequently associated with hormonal factors in women. A thorough medical history taking of vascular risks and an individual evaluation of the risk-benefit ratio should precede any prescription of hormonal therapies. In contrary to progestin-only-pills, estroprogestative contraceptives increase 3-6 times the risk of venous thrombosis. In assisted reproductive techniques, venous thrombosis is frequently associated with the occurrence of a severe ovarian hyperstimulation syndrome. Antagonist ovarian stimulation protocols lower the risk of hyperstimulation and should therefore be preferred. Finally, at menopause, hormonal treatments combining transdermal estradiol and micronized progesterone do not seem to increment the risk of thrombosis.
静脉血栓栓塞症在女性中常与激素因素相关。在进行任何激素治疗处方之前，应全面了解血管风险病史并对风险效益比进行个体评估。与仅含孕激素的避孕药相反，雌孕激素复方避孕药会使静脉血栓形成风险增加3至6倍。在辅助生殖技术中，静脉血栓形成常与严重卵巢过度刺激综合征的发生相关。拮抗剂方案的卵巢刺激可降低过度刺激的风险，因此应优先选用。最后，在绝经后，经皮雌二醇与微粉化孕酮联合的激素治疗似乎不会增加血栓形成风险。
