Oral contraceptive pills and hormonal replacement therapy and thromboembolic disease

The risk of thromboembolic complications with the use of second and third g eneration oral contraceptives is minimal and probably related to underlying congenital or acquired thrombophilic states. Estrogen dose-dependency lead s to increased thrombin generation and increased plasmin generation. There is no convincing evidence that the balance between clotting and fibrinolysi s is disturbed. The risk of venous thromboembolism with pregnancy is greate r than with oral contraceptives. Hormone replacement therapy is safe for he althy women, and the benefits far outweigh the potential risks.