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Re: Contraception and Pulmonary EmbolismFrom: Steve Breaux MD (breauxs@genesishealth.com)Thu Apr 6 15:50:14 2000
At Thu, 6 Apr 2000, Danny Tucker wrote: > >Systemic levels of levonorgestrel with Mirena are about 1/7 of that with use >of the POP, and recent studies suggest no increase in risk of thrombosis >with POP's (although it is 5-6x higher for women using therapeutic >progestogens for menstrual disorders). > >Risk of cardiovascular diseases associated with oral progestagen >preparations with therapeutic indications >Poulter NR, Chang CL, Farley TMM et al. Lancet 1999; 354: 6 November > >Risk of idiopathic venous thromboembolism in users of progestagens alone >Vasilakis C, Jick H & del Mar Melero-Montes M. Lancet 1999; 354: 6 November > >Regards, > >Danny. >I agree with the use of progestins in this case. However, don't forget to read the package insert for your given progestin, DVT/PE are contraindications regardless of what the literature shows. Steve > >-- >Danny Tucker MRCOG >Specialist Registrar, Obstetrics & Gynaecology >Sheffield, UK > >http://www.womens-health.co.uk > >================================================ >A 26 year old mother of 2 had postpartum DVT into the renal vein with >Pulmonary Embolism. An Intracaval filter was inserted. >She is now 6 months postpartum and on oral anticoagulation. >She wont have a BTL. I had to remove a copper IUD due to severe >menorrhagia. >I was considering a progesterone medicated IUD, but concerned about the >small systemic absorption of the hormone and a possible effect on >coagulation. >Any thoughts? >
-- steven breaux
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