Contraceptive counseling for women with inherited thrombophilias
- Tanya Siddiqi, MD
Tanya Siddiqi, MD
- Assistant Professor/Staff Physician
- Department of Hematology/Hematopoietic Cell Transplantation
- City of Hope National Medical Center
- Kenneth A Bauer, MD
Kenneth A Bauer, MD
- Professor of Medicine
- Harvard Medical School
- Robert L Barbieri, MD
Robert L Barbieri, MD
- Editor-in-Chief — Obstetrics/Gynecology and Women's Health
- Section Editor — General Gynecology and Female Reproductive Endocrinology
- Kate Macy Ladd Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
Inherited thrombophilia is a genetic tendency to venous thrombosis (VTE), including deep vein thrombosis (DVT), pulmonary embolism, and cerebral vein thrombosis. Women with an inherited thrombophilia are at higher risk of VTE, especially during use of estrogen-progestin contraceptives and pregnancy. In making contraceptive choices, affected women need to balance the risk of VTE associated with use of various types of hormonal contraception against the risk of VTE associated with an unintended pregnancy resulting from use of less effective contraceptive methods.
This topic will discuss contraceptive counseling for women with an inherited thrombophilia. Other issues related to inherited thrombophilias are reviewed in detail separately:
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- GENERAL PRINCIPLES
- NONHORMONAL METHODS
- PROGESTIN-ONLY METHODS
- ESTROGEN-PROGESTIN METHODS
- Risk of venous thrombosis
- Indications for screening for inherited thrombophilias
- Individualized risk-based counseling
- - Personal history of venous thrombosis
- - Familial, but no personal, history of VTE
- - No personal or family history of VTE, but positive testing for inherited thrombophilia
- - Choice of estrogen-progestin oral contraceptive
- SUMMARY AND RECOMMENDATIONS
- Screening for inherited thrombophilia
- Contraception recommendations