Hormonal contraception and the risk of venous thrombosis: Management recommendations from the Piedmont Region and the Consensus Conference of the Italian National Institute of Health

Hormonal methods are used by many fertile women who require contraception. They are highly effective, but their use is associated with an increased risk of venous thromboembolism. This report summarizes the recommendations of the Public Health Service of Italy's Piedmont Region for the prescription of hormonal contraception (November 2007) and the results of the Consensus Conference of the Italian National Health Institute on the prevention of thromboembolism related to hormonal contraception (July 2009). Although hormonal contraception increases the relative risk for venous thromboembolism, both documents agreed that the absolute risk remains very small. Assessments of eligibility for hormonal contraception must be based on complete medical history that include medical conditions, drugs used, and family history. Unnecessary medical barriers, such as routine screening for thrombophilia, are not recommended. Most women can safely use hormonal contraception. Physicians and women should discuss the risks, benefits, and uncertainties associated with hormonal contraception so that women will be able to make informed decisions regarding their use.