Faculty, Staff and Student Publications
Publication Date
5-1-2023
Journal
Research and Practice in Thrombosis and Haemostasis
DOI
10.1016/j.rpth.2023.100161
PMID
37274174
PMCID
PMC10238261
PubMedCentral® Posted Date
4-24-2023
PubMedCentral® Full Text Version
Post-print
Abstract
There is widespread use of gonadal steroid hormone therapy for a variety of indications throughout the reproductive and postreproductive lifespan. These therapies may have particular benefits and specific risk among those with blood disorders, including inherited or acquired bleeding disorders, thrombophilia, thrombosis, or anemia. This clinical review is intended to provide a guidance for counseling and management of adolescent and adult biologic females with thrombophilic risk factors and/or thrombosis who require hormonal therapy. In general, synthetic estrogens present in contraceptive products should be avoided in those with a personal or strong family history of thrombosis or thrombophilias. In contrast, natural estrogens present in formulations for climacteric symptom management do not need to be avoided, and vaginal or transdermal formulations are preferred. Likewise, transdermal estradiol is preferred for gender-affirming hormone therapy and requires individualized assessment in those at high risk of thrombosis. Progestogens (either synthetic progestins or naturally occurring progesterone) can be used safely in nearly all patients. There is minimal safety evidence among anticoagulated patients at risk for thrombosis, which requires a patient-specific approach when discussing hormone therapies.
Keywords
anemia, estrogen, progestin, thrombophilia, thrombosis
Published Open-Access
yes
Recommended Citation
Baldwin, Maureen K; Samuelson Bannow, Bethany; Rosovsky, Rachel P; et al., "Hormonal Therapies in Females With Blood Disorders: Thrombophilia, Thrombosis, Hemoglobinopathies, and Anemias" (2023). Faculty, Staff and Student Publications. 4260.
https://digitalcommons.library.tmc.edu/uthmed_docs/4260