The use of contraceptives and its relationship with chronic venous insufficiency

Introduction: Combined oral contraceptives (COC's) are widely used due to their efficacy in contraception, with an efficacy rate of up to 99% when used correctly. However, its use is associated with risks, such as the increased risk of venous thrombosis, a serious concern due to the serious implications it may have for women's health. Objective: This study aims to explore the effects of combined oral contraceptives on women's health, with a special focus on the risks associated with venous thrombosis. In addition, it seeks to highlight the fundamental role of pharmacists in guiding and preventing harm related to the use of these drugs. Materials and methods: A systematic and exploratory literature review was carried out, with a search for articles, theses and dissertations in the SciELO, Bireme, LILACS and Web of Science databases, from 2000 to 2024. Studies that explored the relationship between contraceptives and thrombosis, taking into account the inclusion and exclusion criteria, were included. Results: The results of the study indicate that COCs, especially when they contain estrogen, significantly increase the risk of venous thrombosis, especially in women over 40 years of age. This risk is exacerbated by conditions such as genetic predisposition, hypertension, and diabetes, factors with a higher prevalence in this age group. Third- and fourth-generation progestogens have been identified as associated with a higher thrombotic risk compared to second-generation progestogens. Final thoughts: Despite the benefits in contraception and menstrual control, COCs are not without risks, and a careful assessment of the benefits versus the potential individual harms when prescribing these medications is crucial. The role of pharmacists is vital in educating patients about the risks and carefully selecting the safest contraceptives, taking into account factors such as personal and family medical history, genetic predisposition, and preexisting health conditions. This approach aims to maximize the safety and well-being of women who choose to use combined oral contraceptives.