Treatments with estrogens and progestogens are suspected of causing vascular complications either directly or by metabolic consequences. Although many studies have demonstrated an increased incidence of arterial and deep venous thrombosis, since 1970 the dose of estrogens and progesterones have been lowered with a proportional lowering of side effects. After classification of estrogens and progestogens, we studied their peripheral vascular effects. In our study, we demonstrated that the effects of estroprogestogen treatment on the superficial venous system depend on the dose of estrogen and progestogen.
PIP: Physicians examined the charts of 2295 21-40 year old oral contraceptive (OC) users who presented at 2 hospitals in France with venous disorders to determine the effect of various OCs on the functional symptomatology of venous disorders. The hospitals are the Hospital Notre Dame du Bon Secours in Paris and the Hospital Beaujon in Clichy. The various symptoms have existed between more than 1 year and greater than 3 years. The women used OCs with either a monophsic, biphasic, or triphasic minimal dose (304-40 mcg estrogen and 0.15-1 mg progestogen) or a monophasic normal dose (50 mcg estrogen and 500 mg progestogen). Over the course of OC use, the normal dose OC caused more significant intensity of heaviness, pain, and abnormal sensation (e.g., burning, prickling, or formication) than the minimal dose OCs. Other symptoms examined but not significantly affected by estrogen and progestogen dose are cramps and edema. These results and the fact that functional symptomatology appears several years before dilatation with or without reflux of the saphenous veins and other varices indicate that estrogens, progestogens, or their associative action facilitate varicose vein development in individuals with factors which predispose them to vascular disorders (familial history, prolonged standing, obesity, and sedentary). They also aggravate the superficial venous state in these patients.