{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T21:17:41Z","timestamp":1787865461819,"version":"build-2784847793"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004012","name":"Jane ja Aatos Erkon S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","award":["#170062"],"award-info":[{"award-number":["#170062"]}],"id":[{"id":"10.13039\/501100004012","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010114","name":"Yrj\u00f6 Jahnssonin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","award":["20207328"],"award-info":[{"award-number":["20207328"]}],"id":[{"id":"10.13039\/100010114","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The increased risk of venous thromboembolism associated with the use of hormonal contraception is well recognized, but evidence regarding hormonal contraception containing natural estradiol is limited. This study aimed to assess the associations between the patterns of use of different systemic hormonal contraceptives and the risk of venous thromboembolism during 2017\u20132019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>All fertile\u2010aged women (15\u201349\u2009years) living in Finland in 2017 and using hormonal contraception in 2017 and their 1:1 age\u2010 and residence\u2010matched controls not using hormonal contraception in 2017 (altogether 587\u2009559 women) were selected from the Prescription Centre. All incident venous thromboembolism cases during 2018\u20132019 and their 4:1 age\u2010matched controls were further analyzed in a prospective nested case\u2013control design to assess the associations between the use (starting, stopping, continuous vs no use) of different hormonal contraception types and venous thromboembolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Altogether, 1334 venous thromboembolism cases occurred during the follow\u2010up period (incidence rate 1.14 per 1000 person\u2010years, 95% confidence interval [CI] 1.08\u20131.20), with an incidence rate ratio of hormonal contraception vs no hormonal contraception use of 1.42 (95% CI 1.27\u20131.58). Compared with non\u2010use, starting the use of gestodene and ethinylestradiol (adjusted odds ratio [aOR] 2.85; 95% CI 1.62\u20135.03), drospirenone and ethinylestradiol (aOR 1.55; 95% CI 0.98\u20132.44), desogestrel and ethinylestradiol (aOR 1.97; 95% CI 0.99\u20133.92), and transdermal patch releasing norelgestromin and ethinylestradiol (aOR 5.10; 95% CI 1.12\u201323.16), as well as continuing the use of gestodene and ethinylestradiol (aOR 2.60; 95% CI 1.61\u20134.21), drospirenone and ethinylestradiol (aOR 1.55; 95% CI 1.02\u20132.37), cyproterone\u2010acetate and estrogen\/ethinylestradiol (aOR 1.66; 95% CI 1.06\u20132.61), and vaginal ring releasing etonogestrel and ethinylestradiol (aOR 3.27; 95% CI 1.95\u20135.48) were associated with venous thromboembolism risk. Regarding the type of estrogen, the highest risk was associated with current use (vs non use in the previous 180\u2009days) of ethinylestradiol\u2010containing preparations (aOR 2.20; 95% CI 1.82\u20132.65), followed by estradiol\u2010containing preparations (aOR 1.39; 95% CI 1.04\u20131.87) with no risk for progestin\u2010only hormonal contraception. Current use of estradiol\u2010containing preparations was not associated with venous thromboembolism risk after exclusion of cyproterone\u2010acetate and estrogen\/ethinylestradiol (aOR 1.05; 95% CI 0.66\u20131.66).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An increased risk of venous thromboembolism is associated with ethinylestradiol\u2010containing combined preparations. The use of estradiol\u2010containing combined preparations confers only a slightly increased risk, possibly driven by cyproterone\u2010containing combined oral contraceptives, whereas the use of progestin\u2010only contraception is not associated with venous thromboembolism.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14384","type":"journal-article","created":{"date-parts":[[2022,5,28]],"date-time":"2022-05-28T01:36:31Z","timestamp":1653701791000},"page":"846-855","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Systemic hormonal contraception and risk of venous thromboembolism"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-130X","authenticated-orcid":false,"given":"Oskari","family":"Heikinheimo","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6757-7355","authenticated-orcid":false,"given":"Elena","family":"Toffol","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Department of Public Health, Clinicum University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1951-2455","authenticated-orcid":false,"given":"Timo","family":"Partonen","sequence":"additional","affiliation":[{"name":"Mental Health Team, Equality Unit Department of Public Health and Welfare, Finnish Institute for Health and Welfare  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"But","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Department of Public Health, Clinicum University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5695-117X","authenticated-orcid":false,"given":"Antti","family":"Latvala","sequence":"additional","affiliation":[{"name":"Institute of Criminology and Legal Policy University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1450-6208","authenticated-orcid":false,"given":"Jari","family":"Haukka","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Department of Public Health, Clinicum University of Helsinki  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2890"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e2990"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1111840"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-14-0527"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5298"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2921"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2002"},{"key":"e_1_2_12_9_1","unstructured":"Faculty of Sexual & Reproductive Healthcare (FSRH).FSRH Guideline Combined Hormonal Contraception. 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