Risk of Deep Vein Thrombosis and Pulmonary Embolism in Women using Hormonal Contraceptives and Painkillers: Study Findings and Risk Factors

2023-09-08 09:03:50

Painkillers such as ibuprofen, diclofenac and naproxen increased the risk of deep vein thrombosis or acute pulmonary embolism in women who used third- or fourth-generation estrogen-progestin combined oral contraceptives. This increase in risk was less pronounced in women who used painkillers in addition to progestin preparations or hormonal IUDs.

However, the absolute risk of developing a serious blood clot as a result of additionally taking painkillers is low – even in women at high risk: one in every 100,000 women per week

four additional thrombosis or embolism in women not using hormonal contraception, 11 additional events in women using hormonal contraception at intermediate risk, 23 additional events in women using hormonal contraception at high risk

The association was stronger with diclofenac than with ibuprofen and naproxen.

The research team evaluated medical records of two million women aged 15 to 49 in Denmark to uncover possible interactions. They divided hormonal contraception according to the risk of blood clotting disorders. High-risk contraception included combined estrogen and progestin patches, pills, and vaginal rings that contained either 50 mcg of estrogen or third- or fourth-generation progestins. All other combined oral contraceptives and injections fell into the medium risk category, while progestogen-only tablets, implants and hormonal IUDs were classified as low or no risk.

Which: DOI 10.1136/bmj-2022-074450

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