clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2022-100-1-11-17clinmed-338Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESРиск тромбоэмболических осложнений при гормональной терапииRisk of thromboembolic complications during hormone therapyhttps://orcid.org/0000-0002-7426-9040МельниковА. П.Mel’nikovA. P.

Мельников Андрей Павлович — канд. мед. наук, старший научный сотрудник акушерского физиологического отделения МОНИИАГ

101000, Москва

Mel’nikov Andrey P.

101000, Moscow

https://orcid.org/0000-0002-4365-5440ФедоренкоВ. А.FedorenkoV. A.

Федоренко Виктория Александровна — клинический ординатор по специальности акушерство и гинекология МОНИИАГ

101000, Москва

Fedorenko Victoria A.

101000, Moscow

fedorenko.vaf@mail.ruГБУЗ Московской области «Московский областной научно-исследовательский институт акушерства и гинекологии»РоссияMoscow Regional Research Institute of Obstetrics and GynecologyRussian Federation20222204202210011117Copyright © Мельников А.П., Федоренко В.А., 20222022Мельников А.П., Федоренко В.А.Mel’nikov A.P., Fedorenko V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/338

В обзоре представлены современные данные о влиянии гормональных контрацептивов и препаратов гормональной заместительной терапии на риск развития тромбоэмболических осложнений. Обсуждается влияние компонентов препаратов и их дозировок на звенья системы гемостаза, использование гормональной терапии при экстрагенитальных заболеваниях, пути снижения тромбогенного риска гормонов при их обязательном использовании.

The review presents modern data of the effect of hormonal contraceptives and hormone replacement therapy drugs on the risk of thromboembolic complications. The effect of components of the drugs and their dosages on the hemostasis system is presented, the use of hormonal therapy in women with extragenital diseases is discussed, the ways of reducing the thrombogenic risk of hormones with their mandatory use are debated.

комбинированные оральные контрацептивыгормональная заместительная терапиянеоральная контрацепциятромбоэмболические осложненияcombined oral contraceptiveshormone replacement therapynon-oral contraceptionthromboembolic complicationsReferencesNicholson M., Chan N., Bhagirath V., Ginsberg J. Prevention of venous thromboembolism in 2020 and beyond. Clin. Med. 2020;9(8):2467. DOI: 10.3390/jcm9082467Nicholson M., Chan N., Bhagirath V., Ginsberg J. Prevention of venous thromboembolism in 2020 and beyond. Clin. Med. 2020;9(8):2467. DOI: 10.3390/jcm9082467Lidegaard Ø., Nielsen L.H., Løkkegaard E. Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10 BMJ. 2012;344:e2990. DOI: 10.1136/bmj.e2990Lidegaard Ø., Nielsen L.H., Løkkegaard E. Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10 BMJ. 2012;344:e2990. DOI: 10.1136/bmj.e2990Keenan L., Kerr T., Duane M., Van Gundy K. Systematic Review of Hormonal Contraception and Risk of Venous Thrombosis. Linacre Q. 2018;85(4):470–477. DOI: 10.1177/0024363918816683Keenan L., Kerr T., Duane M., Van Gundy K. Systematic Review of Hormonal Contraception and Risk of Venous Thrombosis. Linacre Q. 2018;85(4):470–477. DOI: 10.1177/0024363918816683Abou-Ismail M.Y., Sridhar D.C., Nayak L. Estrogen and Thrombosis: a Bench to Bedside Review. Throm.b Res. 2020;192:40–51. DOI: 10.1016/j.thromres.2020.05.008Abou-Ismail M.Y., Sridhar D.C., Nayak L. Estrogen and Thrombosis: a Bench to Bedside Review. Throm.b Res. 2020;192:40–51. DOI: 10.1016/j.thromres.2020.05.008Manzoli L. Oral Contraceptives and Venous Thromboembolism a Systematic Review and Metaanalysis. Drug. Saf. 2012;35(3):191– 205. DOI: 10.2165/11598050-000000000-00000Manzoli L. Oral Contraceptives and Venous Thromboembolism a Systematic Review and Metaanalysis. Drug. Saf. 2012;35(3):191– 205. DOI: 10.2165/11598050-000000000-00000Römer T. Medical eligibility for contraception in women at increased risk. Dtsch Arztebl. Int. 2019;116(45):764–774. DOI: 10.3238/arztebl.2019.0764Römer T. Medical eligibility for contraception in women at increased risk. Dtsch Arztebl. Int. 2019;116(45):764–774. DOI: 10.3238/arztebl.2019.0764Regidor P.A. The clinical relevance of progestogens in hormonal contraception: Present status and future developments. Oncotarget. 2018;9(77):34628–34638. DOI: 10.18632/oncotarget.26015Regidor P.A. The clinical relevance of progestogens in hormonal contraception: Present status and future developments. Oncotarget. 2018;9(77):34628–34638. DOI: 10.18632/oncotarget.26015Shufelt C.L., Pacheco C., Tweet M.S., Miller V.M. Sex-specific physiology and cardiovascular disease. Adv. Exp. Med. Biol. 2018;1065:433–454. DOI: 10.1007/978-3-319-77932-4_27Shufelt C.L., Pacheco C., Tweet M.S., Miller V.M. Sex-specific physiology and cardiovascular disease. Adv. Exp. Med. Biol. 2018;1065:433–454. DOI: 10.1007/978-3-319-77932-4_27Per Morten Sandset Mechanisms of hormonal therapy related thrombosis. Thromb. Res. 2013;131(1):4–7. DOI: 10.1016/S0049-3848(13)70009-4Per Morten Sandset Mechanisms of hormonal therapy related thrombosis. Thromb. Res. 2013;131(1):4–7. DOI: 10.1016/S0049-3848(13)70009-4Gialeraki A., Valsami S., Pittaras T., Panayiotakopoulos G., Politou M. Oral contraceptives and HRT risk of thrombosis. Clin. Appl. Thromb. Hemost. 2016. DOI: 10.1177/1076029616683802Gialeraki A., Valsami S., Pittaras T., Panayiotakopoulos G., Politou M. Oral contraceptives and HRT risk of thrombosis. Clin. Appl. Thromb. Hemost. 2016. DOI: 10.1177/1076029616683802van Hylckama Vlieg A., Helmerhorst F.M., Vandenbroucke J.P., Doggen C.J., Rosendaal F.R. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study. BMJ. 2009;339:b2921. DOI: 10.1136/bmj.b2921van Hylckama Vlieg A., Helmerhorst F.M., Vandenbroucke J.P., Doggen C.J., Rosendaal F.R. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study. BMJ. 2009;339:b2921. DOI: 10.1136/bmj.b2921Khialani D., Rosendaal F., van Hylckama Vlieg A. Hormonal Contraceptives and the Risk of Venous Thrombosis. Semin. Throm.. Hemos. 2020;46(8):865–871. DOI: 10.1055/s-0040-1715793Khialani D., Rosendaal F., van Hylckama Vlieg A. Hormonal Contraceptives and the Risk of Venous Thrombosis. Semin. Throm.. Hemos. 2020;46(8):865–871. DOI: 10.1055/s-0040-1715793Schindler A.E. Differential effects of progestins on hemostasis. Maturitas. 2003;46(1):31–7. DOI: 10.1016/j.maturitas.2003.09.016Schindler A.E. Differential effects of progestins on hemostasis. Maturitas. 2003;46(1):31–7. DOI: 10.1016/j.maturitas.2003.09.016Eyster K.M. The estrogen receptors: an overview from different perspectives, in Estrogen Receptors. Methods Mol. Biol. 2016;1366:1–10. DOI: 10.1007/978-1-4939-3127-9_1Eyster K.M. The estrogen receptors: an overview from different perspectives, in Estrogen Receptors. Methods Mol. Biol. 2016;1366:1–10. DOI: 10.1007/978-1-4939-3127-9_1Tepper N.K., Dragoman M.V., Gaffi eld M.E., Curti K.M. Non-oral combined hormonal contraceptives and thromboembolism: a systematic review. Contraception. 2017;95(2):130–139. DOI: 10.1016/j.contraception.2016.10.005Tepper N.K., Dragoman M.V., Gaffi eld M.E., Curti K.M. Non-oral combined hormonal contraceptives and thromboembolism: a systematic review. Contraception. 2017;95(2):130–139. DOI: 10.1016/j.contraception.2016.10.005Mantha S., Karp R., Zwicker J.I. Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis. BMJ. 2012;345:e4944. DOI: 10.1136/bmj.e4944Mantha S., Karp R., Zwicker J.I. Assessing the risk of venous thromboembolic events in women taking progestin-only contraception: a meta-analysis. BMJ. 2012;345:e4944. DOI: 10.1136/bmj.e4944Wiegratz I., Bassol S., Merz M. Effect of a low-dose contraceptive patch on effi cacy, bleeding pattern, and safety. Reprod. Sci. 2014;21(12):1518–25. DOI: 10.1177/1933719114532840Wiegratz I., Bassol S., Merz M. Effect of a low-dose contraceptive patch on effi cacy, bleeding pattern, and safety. Reprod. Sci. 2014;21(12):1518–25. DOI: 10.1177/1933719114532840Rafiei F., Tabesh H., Mottaghy K. Development of Hormonal Intravaginal Rings: Technology and Challenges. Geburtshilfe Frauenheilkd. 2021;81(7):789–806. DOI: 10.1055/a-1369-9395Rafiei F., Tabesh H., Mottaghy K. Development of Hormonal Intravaginal Rings: Technology and Challenges. Geburtshilfe Frauenheilkd. 2021;81(7):789–806. DOI: 10.1055/a-1369-9395Brull E.P., Fernandes A., Monteiro I., Bahamondes L., Juliato C.R.T. Safety and bleeding patterns of the levonorgestrel 52-mg intrauterine system among women with thrombosis or coagulopathy. Int. J. Gynaecol. Obstet. 2020;151(3):355–361 DOI: 10.1002/ijgo.13378Brull E.P., Fernandes A., Monteiro I., Bahamondes L., Juliato C.R.T. Safety and bleeding patterns of the levonorgestrel 52-mg intrauterine system among women with thrombosis or coagulopathy. Int. J. Gynaecol. Obstet. 2020;151(3):355–361 DOI: 10.1002/ijgo.13378Gray B., Floyd S., James A.H. Contraceptive Management for Women Who Are at High Risk of Thrombosis. Clin. Obstet. Gynecol. 2018;61(2):243–249 DOI: 10.1097/GRF.0000000000000356Gray B., Floyd S., James A.H. Contraceptive Management for Women Who Are at High Risk of Thrombosis. Clin. Obstet. Gynecol. 2018;61(2):243–249 DOI: 10.1097/GRF.0000000000000356Mari D., Ogliari G., Castaldi D., Vitale G., Bollini E.M., Lio D. Hemostasis and ageing. Immun. Ageing. 2008;5:12. DOI: 10.1186/1742-4933-5-12Mari D., Ogliari G., Castaldi D., Vitale G., Bollini E.M., Lio D. Hemostasis and ageing. Immun. Ageing. 2008;5:12. DOI: 10.1186/1742-4933-5-12Połać I., Borowiecka M., Wilamowska A., Nowak P. Coagulation and fibrynolitic parameters in women and the effects of hormone therapy; comparison of transdermal and oral administration. Gynecol. Endocrinol. 2013;29(2):165-8. DOI: 10.3109/09513590.2012.730567Połać I., Borowiecka M., Wilamowska A., Nowak P. Coagulation and fibrynolitic parameters in women and the effects of hormone therapy; comparison of transdermal and oral administration. Gynecol. Endocrinol. 2013;29(2):165-8. DOI: 10.3109/09513590.2012.730567Barmas-Alamdari D., Sodhi G.S., Spitze A.R. Extensive cerebral venous sinus thrombosis due to medroxyprogestero ne acetate. Neuroophthalmology. 2020;45(1):52–55. DOI: 10.1080/01658107.2020.1797823Barmas-Alamdari D., Sodhi G.S., Spitze A.R. Extensive cerebral venous sinus thrombosis due to medroxyprogestero ne acetate. Neuroophthalmology. 2020;45(1):52–55. DOI: 10.1080/01658107.2020.1797823Hugon-Rodin J., Alhenc-Gelas M., Hemker H.C., Brailly-Tabard S., Guiochon-Mantel A., PluBureau G., Scarabin P.Y. Sex hormone-binding globulin and thrombin generation in women using hormonal contraception. Biomarkers. 2017;22(1):81–85. DOI: 10.1080/1354750X.2016.1204010Hugon-Rodin J., Alhenc-Gelas M., Hemker H.C., Brailly-Tabard S., Guiochon-Mantel A., PluBureau G., Scarabin P.Y. Sex hormone-binding globulin and thrombin generation in women using hormonal contraception. Biomarkers. 2017;22(1):81–85. DOI: 10.1080/1354750X.2016.1204010Arathimos R., Millard L.A.C., Bell J.A., Relton C.L., Suderman M. Impact of sex hormone-binding globulin on the human phenome. Hum. Mol. Genet. 2020;29(11):1824–1832. DOI: 10.1093/hmg/ddz269Arathimos R., Millard L.A.C., Bell J.A., Relton C.L., Suderman M. Impact of sex hormone-binding globulin on the human phenome. Hum. Mol. Genet. 2020;29(11):1824–1832. DOI: 10.1093/hmg/ddz269Simons P.I.H.G., Valkenburg O., Stehouwer C.D.A., Brouwers M.C.G.J. Sex hormone-binding globulin: biomarker and hepatokine? Trends Endocrinol Metab. 2021;32(8):544–553. DOI: 10.1016/j.tem.2021.05.002Simons P.I.H.G., Valkenburg O., Stehouwer C.D.A., Brouwers M.C.G.J. Sex hormone-binding globulin: biomarker and hepatokine? Trends Endocrinol Metab. 2021;32(8):544–553. DOI: 10.1016/j.tem.2021.05.002Kemmeren J.M. et al., Effect of second- and third-generation oral contraceptives on the protein C system in the absence or presence of the factor V (Leiden) mutation: a randomized trial. Blood. 2004;103(3):927–33. DOI: 10.1182/blood-2003-04-1285Kemmeren J.M. et al., Effect of second- and third-generation oral contraceptives on the protein C system in the absence or presence of the factor V (Leiden) mutation: a randomized trial. Blood. 2004;103(3):927–33. DOI: 10.1182/blood-2003-04-1285Ali H.O., Stavik B., Dørum E., Iversen N., Sandset P.M., Skretting G. Oestrogen induced downregulation of TFPI expression is mediated by ERα. Thromb. Res. 2014;134(1):138–43. DOI: 10.1016/j.thromres.2014.04.004Ali H.O., Stavik B., Dørum E., Iversen N., Sandset P.M., Skretting G. Oestrogen induced downregulation of TFPI expression is mediated by ERα. Thromb. Res. 2014;134(1):138–43. DOI: 10.1016/j.thromres.2014.04.004Kline J.A., Richardson D.M., Than M.P., Penaloza A., Roy P.M. Systematic review and meta-analysis of pregnant patients investigated for suspected pulmonary embolism in the emergency department. Acad. Emerg. Med. 2014;21(9):949–59. DOI: 10.1111/acem.12471Kline J.A., Richardson D.M., Than M.P., Penaloza A., Roy P.M. Systematic review and meta-analysis of pregnant patients investigated for suspected pulmonary embolism in the emergency department. Acad. Emerg. Med. 2014;21(9):949–59. DOI: 10.1111/acem.12471

The authors declare that there are no conflicts of interest present.