About this Research Topic
Twenty-two thousand cases of thrombosis occur each year in Europe following the use of combined oral contraceptives (COCs). One of the major challenges for healthcare professionals is to identify women at risk. To this end, several guidelines offer support in tailoring contraception, according to the patient’s profile. However, these strategies rely on epidemiological data and do not allow for an accurate assessment of the risk of venous
thromboembolism at the individual level.
A review of available guidelines (discussing pros and cons) could highlight the gap existing for the detection of coagulopathies in women wishing to start a contraceptive therapy.
In the scope, it is also crucial to discuss the pharmacokinetic and pharmacodynamic profile of each estro-progestin association to better understand the aetiology of associated thrombosis. A research paper on hemostasis discussing the impact on pro-coagulant factors, anti-coagulants ones and on fibrinolysis and the interest of using global coagulation tests as predictive biomarkers could be of interest.
At the present time, there is still some misunderstanding about the classification of COCs with regards to their associated risk of VTE. Indeed, the use of a COC represents a contra-indication in women at risk, but a stratification should be done depending on the type of contraceptives. Estradiol- and estetrol-containing products showed weaker impact on the coagulation system compared to ethinylestradiol-containing product and could therefore be used as an alternative to ethinylestradiol in some patients, depending on their risk,
rather than switching directly to a progestin-only contraceptive, which is generally less well tolerated. This should be the main topic of scientific papers to demonstrate the benefits of these new COCs.
In addition, the choice of the contraceptives should not be restricted to the thrombotic risk alone, but the bleeding profile, acne, weight gain, smoking status and cardiovascular risk are all factors to be considered when prescribing contraceptives.
This aim of this research topic is to highlight that the thrombotic risk is gradual depending on the type of contraceptives (the nature and dosage of the estrogen and progestin compound and the administration route) and that updates of actual guidelines on eligibility for the contraceptive pill is needed.
This Research Topic welcomes contributions of any type (clinical trial, correction, editorial, general commentary, hypothesis & theory, methods, mini review, opinion, original research, perspective, policy and practice reviews, review, study protocol, systematic review, technology and code.) on relevant topics around COC induced coagulopathy.
thromboembolism at the individual level.
A review of available guidelines (discussing pros and cons) could highlight the gap existing for the detection of coagulopathies in women wishing to start a contraceptive therapy.
In the scope, it is also crucial to discuss the pharmacokinetic and pharmacodynamic profile of each estro-progestin association to better understand the aetiology of associated thrombosis. A research paper on hemostasis discussing the impact on pro-coagulant factors, anti-coagulants ones and on fibrinolysis and the interest of using global coagulation tests as predictive biomarkers could be of interest.
At the present time, there is still some misunderstanding about the classification of COCs with regards to their associated risk of VTE. Indeed, the use of a COC represents a contra-indication in women at risk, but a stratification should be done depending on the type of contraceptives. Estradiol- and estetrol-containing products showed weaker impact on the coagulation system compared to ethinylestradiol-containing product and could therefore be used as an alternative to ethinylestradiol in some patients, depending on their risk,
rather than switching directly to a progestin-only contraceptive, which is generally less well tolerated. This should be the main topic of scientific papers to demonstrate the benefits of these new COCs.
In addition, the choice of the contraceptives should not be restricted to the thrombotic risk alone, but the bleeding profile, acne, weight gain, smoking status and cardiovascular risk are all factors to be considered when prescribing contraceptives.
This aim of this research topic is to highlight that the thrombotic risk is gradual depending on the type of contraceptives (the nature and dosage of the estrogen and progestin compound and the administration route) and that updates of actual guidelines on eligibility for the contraceptive pill is needed.
This Research Topic welcomes contributions of any type (clinical trial, correction, editorial, general commentary, hypothesis & theory, methods, mini review, opinion, original research, perspective, policy and practice reviews, review, study protocol, systematic review, technology and code.) on relevant topics around COC induced coagulopathy.
Keywords: oral contraceptives, coagulopathy, thrombosis, thromboembolism
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