Leslie Skeith, Shannon M. Bates
Thrombosis is a recognized complication of sex hormone therapy, which includes hormone replacement for deficiencies, contraceptive therapy, treatment of heavy menstrual bleeding, gender-affirming hormone therapy, suppression of ovulation, oncologic hormone therapy, and assisted reproduction. This review examines the effects of sex hormones on hemostasis and the vasculature and summarizes current evidence on thrombotic risk, including the effects of hormone formulation, thrombophilias, previous thrombosis, and common clinical factors. Practical guidance on the prevention and treatment of hormone-associated venous thromboembolism, as well as on perioperative care of patients receiving sex hormone therapy, is also provided.