Safe control over reproduction is so important and is only going to become even more important in the coming days.
So in addition to the IUD #skeetorial, let’s learn about hormones and thrombosis
#MedSky
1/n
So in addition to the IUD #skeetorial, let’s learn about hormones and thrombosis
#MedSky
1/n
Comments
But in this context, it works!
Estrogen is thought to be the major (but not sole) contributor.
Interestingly the underlying mechanisms behind hormone associated VTE (HAVTE) are not clearly elucidated.
2/n
The earliest OCP contained norethynodrel (a progestin) but was contaminated with mestranol (an estrogen)
When it was removed, women began having breakthrough bleeding so it was put back and became the 1st combined oral contraceptive (COC)
3/n
COCs increase this risk by 3-5 times.
Hormone associated VTE can occur @ any time but are most common in the 1st 3 months of hormone use.
4/n
And control over fertility is so important resulting in ⬇️poverty, fewer deaths related to childbirth, and ⬆️opportunity.
So safe control is paramount!
5/n
Decreasing doses of EE have led to decreasing rates of VTE but no further benefit in <20-30ug.
Thrombotic risk may relate to overall “estrogenicity”
6/n
Depending on the study EE has been shown to affect a lot of coagulation including ⬆️ VWF, fibrinogen, FII, FVII, FVIII, FX, TAFI, APC resistance and ⬇️ protein S, TFPI.
7/n
I like to see that person stabbing the build instead of shooting it!
Then I had an IUD, but it was recalled because of the deaths.
Dalkon Shield, I think.