Contraceptivos hormonais orais e eventos tromboembólicos

Abstract

Hormones are the body's main long-distance communication molecules, being directly involved in the maintenance of various functions. The synthesis of female sex hormones with the aim of inhibiting ovocitation began in the 1950s, being marketed in Brazil in 1970 and becoming one of the most popular contraceptive methods in the country, both because of its practicality of use and because of effectiveness and safety. A narrative literature review was carried out using experimental articles and other literature reviews, including articles that related the effect of the use of oral hormonal contraceptives with the development of thromboembolic conditions, with the use of contraceptives aimed at contraception in women of reproductive age. The relationship between oral contraceptives and the cardiovascular system is much discussed, mainly due to the existence of estrogen and progesterone receptors in all layers of blood vessels. Among the countless beneficial effects brought by these drugs, one of the side effects most associated with the use of oral hormonal contraceptives is thromboembolic events, including venous thrombosis, cerebral thrombosis and pulmonary embolism. There is evidence that oral contraceptives increase blood coagulation factors (mainly factors VII, VIII, IX and X), in addition to decreasing and generating resistance to proteins that down-regulate the coagulation cascade (proteins S and C), thus resulting in a hypercoagulable state and consequently increasing the risk of developing venous thromboembolism. This risk can be further aggravated in some specific formulations, such as third-generation oral contraceptives, and also when the user has some hereditary thrombophilia, in addition to other habits such as smoking and alcohol consumption. It is noted that there was an improvement in the studies of the action of contraceptives in the body, however, investigations are still needed on the effect of these drugs on the hemostatic system, highlighting the need for monitoring by a professional in their prescription.