Risk factors for venous thromboembolism in pre-and postmenopausal women

Risk of venous thromboembolism associated with local and systemic use of hormone therapy in peri- and postmenopausal women and in relation to type and route of administration

“…Details of the study have been published elsewhere. 18 Cases were women, 18 to 64 years of age with a first episode of deep venous thrombosis located in the leg or pelvis or pulmonary embolism, and they were recruited at 43 hospitals in Sweden. All thromboembolic diagnoses were based on objective radiological methods.…”

“…The diagnostic classification based on presence of both a verified radiological examination of VTE and commenced anticoagulant therapy reduces the risk of misclassification. 18 Potential limitations include the possibility of selection bias, the limited sample size, and the lack of laboratory data to define menopause status. Also recall-bias cannot be ruled out as the information on exposure was collected retrospectively, however we tried to minimize this by sending all participants a letter with a memory support catalogue and a time schedule to fill in before the interview.…”

Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)

“…It is believed that these attacks occur more frequently after surgery for obesity and weight-related diseases than after other types of upper abdominal surgery [246]. It is recommended to discontinue estrogen therapy before surgery both in premenopausal and in postmenopausal women to reduce the risk of thromboembolic events in the postoperative period [247]. While the trans-dermal administration of progestogen preparations results in a lower risk of deep vein thrombosis than oral administration [248, 249], there is no data to demonstrate the safety of this treatment in patients who are being considered for surgery for obesity and weight-related diseases.…”

Hormone supplementation for pubertal induction in girls

“…Specifically, the addition of the ethinyl side chain in ethinyloestradiol induces renin substrate at a much greater rate than natural products and increases the risk of hypertension, particularly in susceptible groups such as women with Turner syndrome 28. Use of the COCP is also linked with an increased risk of venous thromboembolism 29. Metabolic studies in adults suggest that ethinyloestradiol treatment gives rise to increased sex hormone binding globulin (SHBG), decreased IGF-1 and increased insulin resistance 11.…”