[Contraception and thrombophilia].

Abstract

CONTRACEPTION AND THROMBOPHILIA. The term thrombophilia includes two different aspects to be considered: the biological aspect with the existence of a hemostasis anomaly activating coagulation and increasing the risk of venous thromboembolic event (VTE), and the clinical aspect with the existence of a first-degree relative having had a venous thromboembolic event at a young age. Systematic screening for biological thrombophilia is not recommended before prescribing hormonal contraception in the absence of a family history or personal event, as it is probably not cost-effective. All combined hormonal contraceptives, whatever the route of administration (oral, patch or vaginal ring) or type of estrogen, are contraindicated in women with biological thrombophilia. Injectable progestin contraception with medroxyprogesterone acetate is also contraindicated. All other contraceptives strategies are authorized: copper or levonorgestrel intrauterine devices (IUD), progestin-only pills, subcutaneous implants, definitive contraception in the case of a completed parental project.