The field of thromboembolism and oral contraceptives is a critical area of research, given the significant number of thrombosis cases linked to the use of combined oral contraceptives (COCs) in Europe annually. A major challenge for healthcare professionals is the identification of women at risk of venous thromboembolism (VTE) when prescribing COCs. Current guidelines provide a framework for tailoring contraception based on patient profiles, yet they predominantly rely on epidemiological data, which falls short in offering precise individual risk assessments. Recent studies have highlighted the need for a more nuanced understanding of the pharmacokinetic and pharmacodynamic profiles of different estro-progestin combinations to elucidate the etiology of associated thrombosis. Despite advancements, there remains a gap in the detection of coagulopathies in women considering contraceptive therapy. Moreover, the classification of COCs concerning their VTE risk is still debated, necessitating further investigation into the stratification of contraceptive types and their impact on the coagulation system.

This research topic aims to explore the gradual thrombotic risk associated with different types of contraceptives, focusing on the nature and dosage of estrogen and progestin compounds, as well as the administration route. The objective is to provide evidence that could inform updates to current guidelines on contraceptive pill eligibility. Key questions include the comparative impact of estradiol- and estetrol-containing products versus ethinylestradiol-containing products on the coagulation system, and the potential benefits of these newer COCs as alternatives for certain patients. Additionally, the research will consider the broader context of contraceptive choice, factoring in bleeding profiles, acne, weight gain, smoking status, and cardiovascular risk.

To gather further insights into the complexities of COC-induced coagulopathy, we welcome articles addressing, but not limited to, the following themes:
- Comparative analysis of different COC formulations and their impact on thrombotic risk.
- Evaluation of current guidelines and their effectiveness in individual risk assessment.
- Pharmacokinetic and pharmacodynamic studies of estro-progestin combinations.
- The role of global coagulation tests as predictive biomarkers for VTE risk.
- Broader considerations in contraceptive choice beyond thrombotic risk, including bleeding profiles and cardiovascular factors.
- Clinical trials and studies on the safety and efficacy of newer COC formulations.
- Policy and practice reviews on contraceptive guidelines and risk stratification

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Frontiers in Endocrinology

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