Hemostatic system in patients with endometrial hyperplasia and the risk of venous thrombosis: А literature review

While treating patients with endometrial hyperplasia, the physician may face both bleeding and thrombotic complications, particularly, during hormonal or surgical treatment, which significantly increases the risk of these complications. In addition, thrombotic complications in gynecological patients may result from congenital or acquired thrombophilia, blood flow disorders (blood stasis), and vascular wall damage, that is, the classic Virchow triad. This study aimed to review the recent scientific literature on the peculiarities of the blood coagulation system in patients with endometrial hyperplasia. The review reflects the results of studies conducted by Russian and foreign authors on the status of the blood coagulation system in patients with endometrial hyperplasia. The features of vascular, thrombocytic, plasma (procoagulant and anticoagulant), and fibrinolytic elements of hemostasis in these patients are considered. The data from the literature on the state of hemostasis before treatment and following hormone therapy and surgical treatment are presented. Moreover, the data of some studies on the genetic features of the hemostatic system in patients with endometrial hyperplasia are summarized. An analysis of the literature indicates the need for a careful choice of drugs and methods of treatment of these patients to avoid venous thromboembolic complications.