Volume 29, Issue 163, September 2025

Thrombotic risk associated with contraceptive choices in women with thrombophilia. A review of the literature

Żanna Gawrysz^1♦, Julia Woźniak², Stanisław Derewjanko², Zofia Cholewa², Joanna Gaik², Karolina Capar²

¹Department of Plastic and Burns Surgery, Multispecialty Hospital in Nowa Sól, ul. Chałubińskiego 7, 67-000 Nowa Sól, Poland
²Collegium Medicum of the University of Zielona Gora, ul. Zyty 28, 65-046 Zielona Góra, Poland

^♦Corresponding author
Żanna Gawrysz, Department of Plastic and Burns Surgery, Multispecialty Hospital in Nowa Sól, ul. Chałubińskiego 7, 67-000 Nowa Sól, Poland

ABSTRACT

Inherited thrombophilia is related to an increased risk of venous thromboembolism. The Factor V Leiden mutation is usually the genetic cause and can be detected using relatively straightforward genetic tests. Using hormonal contraceptives further elevates the risk of thrombosis. Genetic testing could support the personalization of contraceptive therapy by finding women at high risk. Preparing this review, we based it on a targeted literature search on inherited thrombophilia caused by Factor V Leiden and its impact on contraceptive use. We examined data from twenty-two studies published between January 2000 and May 2025 in PubMed and Google Scholar, with a focus on the last decade. The search terms included contraception, venous thromboembolism, thrombophilia, and Factor V Leiden. We included original research, systematic reviews, official guidelines, and case reports. We focused on risk assessment, contraceptive recommendations, and genetic testing. We wanted to draw attention to the problem of thromboembolic disease in women using contraception. It considers the utility of genetic testing in guiding safer clinical decisions. We discussed the role of contraceptives in thrombosis. The prothrombotic effect of oral contraceptive ingredients is well documented. We have presented alternative contraceptive methods, such as non-hormonal options. The decision on choosing the best treatment should take into account the potential risk of thrombosis. It depends on a thorough family history and patient education. Adding genetic screening to clinical practice could be beneficial. However, further studies on the cost-effectiveness and the development of clear guidelines are necessary.

Keywords: inherited thrombophilia, Factor V Leiden, genetic screening, contraception.

Medical Science, 2025, 29, e177ms3679

PDF

DOI: https://doi.org/10.54905/disssi.v29i163.e177ms3679

Published: 25 September 2025