Justason Eve, Ishchuk Anna M, Ott Benjamin P, Gibson M E Sophie, James Paula D
Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
Translational Institute of Medicine (TIME), Queen's Cardio Pulmonary Unit, Queen's University, Kingston, Ontario, Canada.
Haemophilia. 2025 Sep 11. doi: 10.1111/hae.70124.
Von Willebrand disease (VWD) is a bleeding disorder characterized by a deficiency or dysfunction of Von Willebrand factor (VWF) and/or Factor VIII (FVIII), critical coagulation proteins. Individuals with VWD often use combination oral contraceptives (COCs) to manage heavy menstrual bleeding. However, the impact of COCs on VWF and FVIII levels and whether COC use affects VWD diagnosis is unclear.
To review the literature and assess the impact of COCs on FVIII and VWF.
This scoping review used the OVID platform in the MEDLINE, EMBASE and Cochrane databases. Keywords "combination oral contraceptives," "von Willebrand Factor," "Factor VIII" and "von Willebrand Disease" were searched. Primary studies exploring the impact of COCs on VWF and/or FVIII in patients of reproductive age were included. Article titles and abstracts were screened, followed by full-text reviews, data extraction and a meta-analysis.
Twenty-seven studies were included. In healthy patients, 11 studies reported no change in VWF levels, while three found changes in VWF levels. Nine studies reported no change in FVIII levels, while 10 studies observed an increase. In patients with VWD, two studies found no significant change in VWF or FVIII levels. Meta-analysis revealed there was no significant difference in VWF% (Estimate: 2.62 (95%CI -0.5905, 5.831); p value: 0.4033) or FVIII% (Estimate: 2.99 (95%CI -4.85, 10.82); p value: 0.4552) with COC use.
The meta-analysis revealed no difference in VWD or FVIII levels between participants with and without COCs. The lack of observed differences suggests that COCs do not interfere with accurate VWD diagnosis.
血管性血友病（VWD）是一种出血性疾病，其特征是血管性血友病因子（VWF）和/或凝血因子VIII（FVIII）缺乏或功能异常，这两种都是关键的凝血蛋白。患有VWD的个体常使用复方口服避孕药（COC）来治疗月经过多。然而，COC对VWF和FVIII水平的影响以及使用COC是否会影响VWD的诊断尚不清楚。
回顾文献并评估COC对FVIII和VWF的影响。
本范围综述使用OVID平台检索MEDLINE、EMBASE和Cochrane数据库。检索关键词为“复方口服避孕药”、“血管性血友病因子”、“凝血因子VIII”和“血管性血友病”。纳入探索COC对育龄期患者VWF和/或FVIII影响的原始研究。先筛选文章标题和摘要，然后进行全文审阅、数据提取和荟萃分析。
共纳入27项研究。在健康患者中，11项研究报告VWF水平无变化，3项研究发现VWF水平有变化。9项研究报告FVIII水平无变化，10项研究观察到FVIII水平升高。在VWD患者中，2项研究发现VWF或FVIII水平无显著变化。荟萃分析显示，使用COC后VWF%（估计值：2.62（95%置信区间-0.5905，5.831）；p值：0.4033）或FVIII%（估计值：2.99（95%置信区间-4.85，10.82）；p值：0.4552）无显著差异。
荟萃分析显示，使用和未使用COC的参与者之间VWD或FVIII水平无差异。未观察到差异表明COC不会干扰VWD的准确诊断。
