An opinion on the benefits of concomitant oral contraceptive therapy in premenopausal women treated with oral anticoagulants

Women who are receiving an oral anticoagulant appear to be at higher risk of developing bleeding-related adverse events than men. Physiological bleeding related to the ovulatory cycle poses an ongoing risk for bleeding complications during anticoagulant therapy. Abnormal uterine bleeding and hemorrhagic ovarian cysts are risks specific to women of reproductive age who are treated with anticoagulants. The use of combined oral contraceptives can help minimize such adverse events and would also mitigate the risks of obstetrical complications related to thrombosis and anticoagulation, in addition to avoiding fetal exposure to potentially teratogenic anticoagulants. Clinicians tend to interrupt oral contraceptives in women who are receiving oral anticoagulants despite the absence of evidence that they increase thrombotic risks when taken concurrently. This letter of opinion aims to support the use of oral contraceptives, when clinically indicated, in women of reproductive age who also are receiving an oral anticoagulant.