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

  title={Sex hormone‐binding globulin as a marker for the thrombotic risk of hormonal contraceptives},
  author={Marjolein Raps and Frans M. Helmerhorst and Kathrin Fleischer and Stella Thomassen and Frits Richard Rosendaal and Jan Rosing and Bart E P B Ballieux and Huib Aam van Vliet},
  journal={Journal of Thrombosis and Haemostasis},
Summary.  Background: It takes many years to obtain reliable values for the risk of venous thrombosis of hormonal contraceptive users from clinical data. 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 (SHBG) might serve as a marker for the risk of venous thrombosis, and can be easily and rapidly measured in routine laboratories. 

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.

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 and thrombin generation in women using hormonal contraception

In hormonal contraceptive users, SHBG was positively associated with both activated protein C (APC) resistance and baseline TG, and protein S and prothrombin were important mediators.

Oral Contraceptives and HRT Risk of Thrombosis

This review attempts to summarize the current knowledge regarding the pathophysiology of oral contraceptive (OC) and hormone replacement therapy (HRT) -induced prothrombotic state in women, the risk of thrombosis associated with administration of various commercially available OCs and HRT, the additional risk in women with hereditary or acquired thromBophilia, and the currently available recommendations.

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.

Endogenous sex hormones and risk of venous thromboembolism in young women

The risk of venous thromboembolism (VTE) in young women can predominantly be attributed to exogenous hormone use. The influence of (abnormalities in) endogenous sex hormones, as in polycystic ovary

The effect of different hormonal contraceptives on plasma levels of free protein S and free TFPI.

The effect of oral contraceptives on TFPI and PS is a possible explanation for the increased risk of venous thrombosis associated with oral contraceptives.



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

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.

Prothrombotic changes in users of combined oral contraceptives containing drospirenone and cyproterone acetate

Thrombin generation-based activated protein C (APC) sensitivity is a global test for the net prothrombotic effect and predicts the risk of venous thrombosis.

Estrogens, progestogens and thrombosis

The risk of arterial disease in oral contraceptive users and users of hormone replacement therapy is at most weakly affected by the presence of prothrombotic abnormalities.

Effects of Oral and Transdermal Hormonal Contraception on Vascular Risk Markers: A Randomized Controlled Trial

Oral and transdermal contraception with similar hormones had similar adverse effects on vascular risk markers, which suggests that this transDermal contraceptive has at least a similar thrombosis risk as its oral counterpart.

The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study

A high risk of venous thrombosis during the first months of oral contraceptive use irrespective of the type of oral contraceptives is confirmed, and many women do not use the safest brands.

Activated protein C resistance determined with a thrombin generation‐based test predicts for venous thrombosis in men and women

A high APCsr, determined with the thrombin‐generation‐based APC resistance test, predicts venous thrombotic risk, in populations with and without factor V Leiden.

The effect of the levonorgestrel-releasing intrauterine system on the resistance to activated protein C (APC).

In this study, it is observed that the levonorgestrel-intrauterine system decreases the resistance to APC which indicates that thelevonorgESTrel-intervention system does not have a prothrombotic effect.

Hormone therapies and venous thromboembolism: where are we now?

The current knowledge on the risk of venous thrombosis associated with premenopausal hormone use for contraception and with post menopausal hormone replacement therapy is reviewed.