Abstract
Objective. To review the literature presenting cases of venous thromboembolism (VTE) in women taking combined oral contraceptives (COCs) containing different progestogens. Materials and methods. The search was performed in interdisciplinary databases (PubMed, Scopus, Research Gate, Google Scholar, ClinicalTrials, Cochrane Library) using the following key words: combined oral contraceptives, hormone therapy, estrogen, progestogen, contraception, thrombotic risk, and deep vein thrombosis. Results. With limiting the publication date to a 12-year period (2012–2024), 314 papers were found, among which only 26 fully met the objective. In all selected publications, the minimal risk of VTE with COC use was associated with levonorgestrel when the ethinylestradiol dose was less than 50 mcg. The presented analysis shows that there is no unambiguous opinion about the advantages of any 3rd–4th generation progestogen in COCs in relation to VTE risks, except for a study from Japan, according to which the incidence of VTE when using COCs with drospirenone is almost 17 (!) times higher than when using COCs with levonorgestrel. Conclusion. It remains unclear why the risks of thrombotic complications differ with the same concentration of ethinylestradiol in various COCs. It can be assumed that some progestogens, to a greater extent than other members of this class, either (a) enhance the procoagulant effect of ethinylestradiol, or (b) on the contrary, are able to suppress it more intensively. Key words: combined oral contraceptives, hormone therapy, estrogen, progestogen, contraception, thrombotic risk and deep vein thrombosis
Published Version
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