Factor V Leiden and venous thromboembolism: risk associated with hormone replacement therapy.
OBJECTIVE
To determine the risk-benefit ratio of hormone replacement therapy (HRT) and the cost-effectiveness of screening in perimenopausal and postmenopausal women who are carriers of factor V Leiden, as well as to provide evidence-based clinical recommendations for the primary care provider.


METHODS
Databases searched included EMBASE, BIOSIS, MEDLINE, CINAHL, PubMed, SciSearch, and the Cochrane Database. Two reviewers extracted, reviewed, and concurred upon relevant evidence identified in the data-bases.


RESULTS
Results confirmed that all women have a higher risk for the development of venous thrombosis while on HRT. The presence of a genetic mutation, such as factor V Leiden, in combination with HRT dramatically increased an individual's chance for developing venous thrombi.


CONCLUSIONS
Based on the findings of the studies reviewed, it is recommended that women wishing to initiate HRT be thoroughly screened for known risk factors of thrombosis. If risk factors are identified, genetic testing for factor V Leiden may be warranted.
Park
Brandon Dee
BD
Family Nurse Practitioner Program, Brigham Young University, Provo, Utah, USA.
Lookinland
Sandra
S
Beckstrand
Renea L
RL
Chasson
Susan
S
D020016:Activated Protein C Resistance / Q000235:genetics*; D016022:Case-Control Studies; D005165:Factor V / Q000235:genetics*; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020246:Venous Thrombosis / Q000209:etiology*
C095381:factor V Leiden; D005165:Factor V