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Thromboembolism in women
Authors:Martinelli Ida
Affiliation:A Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Internal Medicine and Medical Specialties, Foundation IRCCS Policlinico, Mangiagalli and Regina Elena, University of Milan, Milan, Italy. martin@policlinico.mi.it
Abstract:Venous thromboembolism (VTE) occurs in one of every 1,000 individuals per year. The incidence is much lower in young persons. In persons younger than age 45, the incidence is one of every 10,000 individuals per year. VTE is a multifactorial disease due to the interaction of various risk factors that can be genetic (e.g., inherited thrombophilia), acquired (e.g., age, neoplastic or autoimmune diseases, antiphospholipid antibodies), or transient (e.g., surgical interventions, fractures, trauma, prolonged immobilization). VTE is found equally in the two sexes. There are other transient risk factors for VTE that are typical for females, and these render women more exposed than men to the risk of the disease during their lifetime. Such risk factors are encountered frequently in a woman's life; they are oral contraceptive (OC) use, hormone replacement therapy, and pregnancy/puerperium. Moreover, various obstetric complications have attributed at least in part to an impaired placental circulation, suggesting a thrombosis theory as their common basis. In this review, the relationship between VTE and risk factors specifically of women is discussed, also in relation to coagulation abnormalities causing inherited thrombophilia.
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