Thrombotic Complications in Women: Risks and Prevention

Abstract

Two main clinical manifestations of venous thrombo-embolism (VTE) include deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT refers to a blood clot that starts in vein, usually in the deep veins of the legs or pelvis area. This blood clot (thrombus) may dislodge from its site of generation and travel through blood stream into lungs, causing PE, a potentially fatal condition. While incidence rate of VTE vary among different age groups and population, various reports are available on its differential occurrence in men and women, with contrasting data. Although any individual can succumb to VTE due to various inherited and acquired risk factors, the majority of the published data indicates that women are more prone to first incidence of venous thrombosis during different stages of life (from puberty till menopause), while men are more prone to recurrent VTE. The prevention and treatment of VTE thus poses distinct gender-specific challenges. It is extremely important for women to know the stages of life when they are more prone to develop DVT/VTE. Subsequently, women also need to have information about the risks associated with treatments using oral contraceptives, ovarian stimulation, pregnancy, etc. Thus the aim of this review is to (1) assess the incidence and risk factors of VTE in women and (2) to summarize the current guidelines and recommendation of VTE management. Early diagnosis of signs and symptoms of DVT/VTE and use of systematic anticoagulation therapy can prevent progression of thrombus and subsequent PE.