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Certain contraceptives may increase risk for thrombotic events in women with obesity


September 15, 2022

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Disclosures: The authors report no related monetary disclosures.


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Use of mixed oral contraceptives in girls with weight problems could confer elevated CV threat within the type of venous and arterial thromboembolism, researchers reported.

In a assessment printed in ESC Coronary heart Failureresearchers acknowledged that particular consideration could also be wanted when assessing CV threat in girls with weight problems who, with their doctor, are weighing the most secure possibility for contraception.



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“Weight problems is … a serious problem in cardiovascular sufferers. Certainly, adiposity exacerbates cardiac dysfunction together with hypertrophy, worsens cardiac insulin resistance, and reduces basal and insulin-stimulated glucose oxidation charges,” Giuseppe MC Rosano, MD, PhD, guide heart specialist and professor of cardiology, Heart for Scientific and Primary Analysis, division of medical sciences at IRCCS San Raffaele Pisana in Rome, and colleagues wrote. “Contraceptive use is one other well-known cardiovascular threat issue, being related to elevated thrombotic threat.

“As such, each these situations are conceived as doubtlessly reversible threat components,” the researchers wrote. “Their results on cardiovascular outcomes are more and more acknowledged.”

Rosano and colleagues carried out a story assessment to evaluate the mixed impact of weight problems and contraceptive use on threat for venous and arterial thromboembolic occasions.

Mixed oral contraceptive use induces a procoagulant state, alters oxidative homeostasis and modifies the low-grade inflammatory state in girls who use them, which can enhance the chance for VTE, in keeping with the assessment.

Consequently, CV threat, primarily threat for VTE, is 12 to 24 occasions better in girls with weight problems who use mixed oral contraceptives in contrast with girls with out weight problems who don’t use mixed oral contraceptives, in keeping with the assessment.

The researchers cited proof printed within the Worldwide Journal of Weight problems and Associated Metabolic Problems that confirmed progestin-only contraceptive merchandise could not enhance dangers for VTE and arterial thromboembolic occasions; nevertheless, doubts stay relating to injectable progestin-only depot medroxyprogesterone, in keeping with the assessment.

Due to this fact, Rosano and colleagues beneficial that weight problems and life-style be thought of when prescribing hormonal contraception because of this extra threat related to mixed oral contraception, and that progestin-only merchandise could also be a safer different in girls with weight problems.

“On condition that VTE dangers are likely to affiliate in the identical topic and that obese/weight problems may be related to cigarette smoking, arterial hypertension and age, it’s essential to evaluate the consolidated thrombotic threat ensuing from the presence of every VTE threat if current in the identical topic,” the researchers wrote. “The advice is to train warning with using mixed oral contraceptives in sufferers with obese and weight problems, selecting the most secure options when prescribing hormonal contraception because of the rising world prevalence of weight problems.”

See the doc for full particulars of the info assessment and the researchers’ suggestions.

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