The Jean Hailes women’s health week started in Australia in 2012 and is the largest event dedicated to the health and wellbeing of women, girls and gender-diverse people. The topics this year include hormones, PCOS, menopause and heart health.

For more information about the event please visit the website Women's Health Week. 

Perth Blood Institute (PBI) would like to commemorate the occasion by sharing important information about PCOS, menopause and heart health, as these all are linked to an increased risk of blood clots.

Hormones

Women are at a higher risk of venous thromboembolism (VTE) if they use oestrogen-containing contraceptives or hormone replacement therapy (HRT). Research has found that oral contraceptives affect coagulation factors and proteins involved in the fibrinolytic pathway, which is a process that removes fibrin (a fibrous mesh that impedes the flow of blood) from the vascular system, preventing clots from blocking vessels. Oestrogen has an impact on haemostasis (balance between procoagulation and anticoagulation processes) and when there is an imbalance there is an increased risk of the development of thrombi.

Menopause

For post-menopausal women using HRT, blood clots are a possible complication, especially with oral oestrogen HRT. An analysis of the types of HRT used found that non-oral HRT was not associated with increased probability of thrombosis and that transdermal (via the skin) HRT provides the lowest risk.

Polycystic ovarian syndrome (PCOS)

PCOS is one of the most common endocrine system and reproductive disorders among women, with the global prevalence in 2020 being 5-20%. PCOS is multifaceted, affecting not only the reproductive system, but also the cardiovascular system.

In 2020, research found that women with PCOS have a 1.5-2.0-fold increased risk of VTE compared to women without the condition. To read more, please visit PBI - PCOS & thrombosis.

Heart health

Cardiovascular disease (CVD) is the main cause of mortality in women, with data from 2019 showing that CVD attributed to 35% of all female deaths globally. This translates to approximately 275.2 million cases worldwide. Coronary heart disease was the main cause of CVD mortality in 2019, with stroke the second reason. Both these conditions are generally caused by a blockage that prevents blood flowing to the heart or brain.

In 1884, Rudolph Virchow (a physician and pathologist) suggested that thrombosis was the result of [among others] the stasis of blood flow, which since then has been recognised as a risk factor. Therefore, heart health and maintaining blood flow throughout the body is paramount to reducing the risk of VTE.

Please visit our website on CVD and thrombosis for more information.

Autoimmune disorders

Systemic autoimmune diseases affect 78% of women compared to men. Some common autoimmune disorders include Celiac Disease, Multiple Sclerosis, Rheumatoid Arthritis and Systemic Lupus Erythematosus. The chronic inflammation produced by an autoimmune disorder is linked to a breakdown of the endothelium (tissue that forms the lining of blood vessels), which leads to the acceleration of atherosclerosis, a major cause of CVD.

As women are more at risk for VTE, including deep vein thrombosis and pulmonary embolism, it is vital we maintain good health and preventative measures to reduce the risk. PBI's website provides several tools and information to help - Women and the risk of blood clots.

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References

• Risk Factors for Venous Thromboembolism (ahajournals.org)
• Autoimmune disorders: MedlinePlus Medical Encyclopedia
• Fibrinolytic System - an overview | ScienceDirect Topics
• Vogel, B. et al. (2021). The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030. The Lancet, 397 (10292). 2385-2438.
• Tchaikovski, S.N. & Rosing, J. (2010). Mechanisms of Estrogen-Induced Venous Thromboembolism, Thrombosis Research, 126 (1). Pages 5-11.