Can changes in sex hormone binding globulin predict the risk of venous thromboembolism with combined oral contraceptive pills?

@article{Odlind2002CanCI,
  title={Can changes in sex hormone binding globulin predict the risk of venous thromboembolism with combined oral contraceptive pills?},
  author={Viveca Odlind and Ian Milsom and Ingemar R. Persson and Arne Victor},
  journal={Acta Obstetricia et Gynecologica Scandinavica},
  year={2002},
  volume={81}
}
Background. Recent studies have indicated that the risk of thromboembolic disease (VTE) in users of combined oral contraceptive pills (COCs) varies not only with estrogen dose, but also with the progestogen in pills with the same estrogen dose. The aim of this article is to discuss sex hormone binding globulin (SHBG) as a marker of estrogenicity and as a surrogate indicator for the potential risk of VTE in users of COC. 

Sex hormone‐binding globulin levels are not causally related to venous thrombosis risk in women not using hormonal contraceptives

Oral contraceptive use increases the risk of venous thrombosis as well as sex hormone‐binding globulin (SHBG) levels and increased SHBG levels are positively associated with activated protein C (APC) resistance andThrombotic risk in oral contraceptive users.

Sex hormone‐binding globulin as a marker for the thrombotic risk of hormonal contraceptives

Measurement of activated protein C (APC) resistance via thrombin generation is a validated test for determining the thrombogenicity of hormonal contraceptives.

Sex hormone‐binding globulin as a marker for the thrombotic risk of hormonal contraceptives: a rebuttal

When measured only in women on-treatment SHBG showed a very weak association with normalized activated protein C sensitivity ratios (nAPCsr) determined with the thrombin generation-based APC resistance test, in their opinion SHBG is not a surrogate marker for venous thrombosis.

MECHANISMS IN ENDOCRINOLOGY Epidemiology of hormonal contraceptives-related venous thromboembolism

Current data support that newer generation formulations of hormonal contraceptives as well as non-oral hormonal contraceptives seem to be more thrombogenic than second-generation hormonal contraceptives.

Effect of ethinylestradiol dose and progestagen in combined oral contraceptives on plasma sex hormone‐binding globulin levels in premenopausal women

The effect of a combined oral contraceptive on sex hormone binding globulin (SHBG) levels may be an indicator for venous thrombosis risk of the COC involved and users of COC containing a third generation progestagen have higher SHBG levels than second generation progESTagen users reflecting the difference in venousThromBosis risk.

Mechanisms of estrogen-induced venous thromboembolism.

Epidemiology of hormonal contraceptives-related venous thromboembolism.

Current data support that newer generation formulations of hormonal contraceptives as well as non-oral hormonal contraceptives seem to be more thrombogenic than second-generation hormonal contraceptives.

Mechanisms of hormonal therapy related thrombosis.

  • P. Sandset
  • Medicine, Biology
    Thrombosis research
  • 2013
...

References

SHOWING 1-10 OF 64 REFERENCES

Oral contraceptives and thromboembolic disease: effects of lowering oestrogen content.

The introduction of low-oestrogen oral contraceptives in Sweden and the concomitant disappearance of high-dose preparations did not result in a lowering of the mortality of fertile women from

Oral contraceptives and venous thrombosis: different sensitivities to activated protein C in women using second‐ and third‐generation oral contraceptives

It is known that a mutation in factor V (factor VLeiden), which results in resistance to activated protein C (APC) and which is the most common cause of hereditary thrombophilia, potentiates the prothrombotic effect of OC.

A metabolic assessment of different oral contraceptives

The demonstration in the late 1960s that the risk of developing thrombo-embolic disease was increased in women using oral contraceptives and that the magnitude of the risk was correlated with the oestrogen dose led to the withdrawal of formulations of oral contraceptives containing more than 50 μg of ethinyloestradiol, and the choice of an oral contraceptive was considerably narrowed.

Progestagen-dependent effect on some plasma proteins during oral contraception.

Oral contraception with both preparations induced a similar, significant rise in both ceruloplasmin and pregnancy-associated protein, and sex hormone binding globulin levels rose significantly with the ethinyl estradiol-desogestrel-levonorgestrel combination.

Pharmacodynamic Studies on Desogestrel Administered Alone and in Combination with Ethinylestradiol

  • G. Cullberg
  • Medicine, Biology
    Acta obstetricia et gynecologica Scandinavica. Supplement
  • 1985
Most progestogens in oral contraceptives are testosterone derivatives and have androgenic side effects such as weight increase, acne and hirsutism. They pose a problem to many women just like the
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