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Which Hormones and Contraception for Women with APS? Exogenous Hormone Use in Women with APS

  • Antiphospholipid Syndrome (S Zuily, Section Editor)
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Abstract

Purpose of Review

Use of exogenous estrogen carries significant risk for patients with prothrombotic disorders including those with antiphospholipid antibody (aPL) and antiphospholipid syndrome (APS). This review summarizes current knowledge of contraceptive and other hormone therapies for aPL-positive and APS women and highlights knowledge gaps to guide future research.

Recent Findings

Studies support very low risk for most progestin-only contraceptives in patients with increased thrombotic risk, but suggest increased VTE risk with depot-medroxyprogesterone acetate.

Summary

Highest efficacy contraceptives are intrauterine devices and subdermal implants, and these are recommended for women with aPL/APS. Progestin-only pills are effective and low risk. Perimenopausal symptoms may be treated with nonhormone therapies in aPL/APS patients: vasomotor symptoms can improve with nonhormonal medications and cognitive behavioral therapy, and genitourinary symptoms often improve with intravaginal estrogen that has limited systemic absorption.

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  1. Weill Cornell Medicine, New York, NY, 10021, USA

    Lisa R. Sammaritano

  2. Hospital for Special Surgery, New York, NY, 10021, USA

    Lisa R. Sammaritano

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Sammaritano, L.R. Which Hormones and Contraception for Women with APS? Exogenous Hormone Use in Women with APS. Curr Rheumatol Rep 23, 44 (2021). https://doi.org/10.1007/s11926-021-01006-w

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