ArticleBlood2016
Recurrent venous thromboembolism and abnormal uterine bleeding with anticoagulant and hormone therapy use.
Article in Blood, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
71 citing papers in PubMed, 2 syntheses or guidelines pooled it, 207 citations in OpenAlex.
- Interdisciplinary management of gynecologic bleeding with anticoagulation: a recommended toolkit from the Foundation for Women and Girls with Blood Disorders+ Thrombosis Subcommittee.Journal of thrombosis and haemostasis : JTH · 2025Guideline
- Comprehensive Outpatient Management of Low-Risk Pulmonary Embolism: Can Primary Care Do This? A Narrative Review.The Permanente journal · 2020Pooled it
- Heavy Menstrual Bleeding in Women Treated with Direct Oral Anticoagulants: Results of the Prospective HEMBLED Registry.Thrombosis and haemostasis · 2026Trial
- Abnormal vaginal bleeding in women of reproductive age treated with edoxaban or warfarin for venous thromboembolism: a post hoc analysis of the Hokusai-VTE study.BJOG : an international journal of obstetrics and gynaecology · 2018Trial
- Combining value of information analysis and ethical argumentation in decisions on participation of vulnerable patients in clinical research.BMC medical ethics · 2018Trial
- Venous thromboembolism in women on estrogen therapy: presentation, management, and outcomes in the RIETE registry.Blood advances · 2026Article
- Estrogen-associated thrombosis and the road not taken.Blood advances · 2026Article
- Using updated clinical recommendations to support contraceptive decision-making: U.S. medical eligibility criteria for contraceptive use, 2024.Contraception · 2026Review
- Review
- Implementing anticoagulation stewardship: the use of a dedicated mobile phone 'app' in the experience of the Italian Federation of Anticoagulation linics (FCSA).Journal of thrombosis and thrombolysis · 2026Article
- Sex Differences in Cancer-Associated Thrombosis.International journal of molecular sciences · 2026Review
- Risk and management of congenital thrombophilia in transgender individuals undergoing gender-affirming hormone therapy.International journal of transgender health · 2026Article
- Prevalence of abnormal uterine bleeding and quality of life after venous thromboembolism by oral anticoagulant use: the GENB-OAC Study.Research and practice in thrombosis and haemostasis · 2026Article
- Complex Venous Thromboembolism in a Young Woman With Multisystem Manifestations: A Case Report.Cureus · 2025Article
- Patient-centered management of heavy menstrual bleeding while on anticoagulation: A survey study.European journal of obstetrics, gynecology, and reproductive biology · 2025Article
- Safe and effective anticoagulation use: case studies in anticoagulation stewardship.Journal of thrombosis and haemostasis : JTH · 2025Review
- Gender-affirming hormone therapy in the transgender patient: influence on thrombotic risk.Hematology. American Society of Hematology. Education Program · 2024Review
- Hormone-related thrombosis: duration of anticoagulation, risk of recurrence, and the role of hypercoagulability testing.Hematology. American Society of Hematology. Education Program · 2024Review
- Article
- U.S. Medical Eligibility Criteria for Contraceptive Use, 2024.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2024Article
11 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 11 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Women receiving vitamin K antagonists (VKAs) require adequate contraception because of the potential for fetal complications. It is unknown whether the use of hormonal therapy, especially those containing estrogens, is associated with recurrent venous thromboembolism (VTE) during anticoagulation. Despite the absence of data, World Health Organization guidelines state that use of estrogen-containing contraceptives confers an "unacceptable health risk" during established anticoagulation for VTE. We compared the incidences of recurrent VTE and abnormal uterine bleeding with and without concomitant hormonal therapy in women aged <60 years who were receiving anticoagulation with rivaroxaban or enoxaparin/VKA for confirmed VTE. Incidence densities in percentage per year were computed for the on and off estrogen-containing or progestin-only therapy periods. Cox regression models were fitted, with hormonal therapy (on vs off) as a time-dependent variable to derive the hazard ratio (HR) for the effects on recurrent VTE and abnormal uterine bleeding. In total, 1888 women were included. VTE incidence densities on and off hormonal therapy were 3.7%/year and 4.7%/year (adjusted HR, 0.56; 95% confidence interval [CI], 0.23-1.39), respectively, and were 3.7%/year and 3.8%/year, respectively, for estrogen-containing and progestin-only therapy. The adjusted HR for all abnormal uterine bleeding (on vs off hormonal therapy) was 1.02 (95% CI, 0.66-1.57). Abnormal uterine bleeding occurred more frequently with rivaroxaban than with enoxaparin/VKA (HR, 2.13; 95% CI, 1.57-2.89). Hormonal therapy was not associated with an increased risk of recurrent VTE in women receiving therapeutic anticoagulation. The observed increased risk of abnormal uterine bleeding with rivaroxaban needs further exploration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.