VTE and anticoagulation in menstruating women

Abstract

Women of childbearing potential have a high prevalence of venous thromboembolism (VTE) due to high estrogen states, such as pregnancy and the use of estrogen-containing contraceptives. Abnormal uterine bleeding (AUB) affects up to two-thirds of menstruating women on anticoagulation (AC), and can severely impair a woman's quality of life. Rates of heavy menstrual bleeding (HMB) and other forms of AUB including inter-menstrual and postmenopausal bleeding are consistently underreported in the original clinical trials utilizing AC. VTE can occur at any time in a woman's life, and the aim of this review article is to discuss the current landscape of literature on AUB for women on AC, VTE and AC in women of child bearing potential, planning for pregnancy while on AC, VTE during pregnancy, and considerations for VTE risk in postmenopausal women. This survey of the current literature may offer data for providers to consider while making clinical decisions on the duration of and appropriate choice of anticoagulation.

Keywords

• Women's health
• Thrombosis
• Anticoagulation
• Oral anticoagulants
• Estrogenassociated thrombosis
• Hormones and thrombosis