ORIGINAL ARTICLESThrombophilia and the risk of thromboembolic events in women on oral contraceptives and hormone replacement therapyDeSancho, Maria Ta,b; Dorff, Tanyac; Rand, Jacob Hd,eAuthor Information aWeill Medical College of Cornell University, USA bDivision of Hematology and Medical Oncology, Department of Medicine, New York Presbyterian Hospital-Cornell Medical Center, New York, New York, USA cUSC Keck School of Medicine, Los Angeles, California, USA dAlbert Einstein College of Medicine, USA eDepartments of Pathology and Medicine, Montefiore Medical Center, Bronx, New York, USA Received 24 October, 2009 Revised 12 April, 2010 Accepted 17 April, 2010 Correspondence to Maria T. DeSancho, MD, MSc, Associate Clinical Professor of Medicine, Division of Hematology and Medical Oncology, New York Presbyterian Hospital-Cornell Medical Center, 525 East 68th Street, New York, NY 10021, USA Tel: +1 212 746 9051; fax: +1 212 746 8869; e-mail: email@example.com Blood Coagulation & Fibrinolysis: September 2010 - Volume 21 - Issue 6 - p 534-538 doi: 10.1097/MBC.0b013e32833b2b84 Buy Metrics Abstract Thrombophilia contributes to the risk of thrombosis in women using female hormones. The objective of the present study was to evaluate the prevalence of thrombophilia in women with thromboembolic events (TEEs) using oral contraceptives or hormone replacement therapy (HRT) and assess the contribution of a family history and the duration of hormone use in predicting thrombosis. A retrospective analysis was performed of the case records of women who developed a TEE while on oral contraceptives or HRT and were referred for thrombophilia evaluation over a 4-year period. Among 85 women who developed a TEE while on oral contraceptives or HRT, 65 had at least one additional thrombophilia risk factor. Of the 85 cases, 23 tested positive for more than two thrombophilias, 16 had factor V Leiden, five had the prothrombin gene G20210A polymorphism, 26 had antiphospholipid antibodies, 10 had elevated homocysteine, four had protein C deficiency, and seven had protein S deficiency. There were 64 TEE: 16 pulmonary emboli, 17 cerebrovascular events, 11 intra-abdominal thromboses, 13 deep venous thromboses, five cases of superficial thrombophlebitis, and two retinal vein thromboses. Of the 65 women, 37% had a positive family history of thrombosis. Approximately half of the women had been taking oral contraceptives or HRT for more than 1 year. There is a high prevalence of thrombophilia in women who developed a TEE while using oral contraceptives or HRT for more than 1 year. Family and personal history of thrombosis should be carefully evaluated in all women before initiating or continuing oral contraceptives or HRT, and a positive history may warrant a thrombophilia screening. © 2010 Lippincott Williams & Wilkins, Inc.