A gentle reminder for contraceptive providers, Pl counsel about the duration of Pill intake after measuring BP & F/H/O VTE, MI etc. Let us quickly recapitulate why very occasionally an Indian woman develop venous thrombosis when she is on OCP (COC) specially if she is on high dose for long yrs without the knowledge of the provider. Indian women are relatively immune to VTE. Blessings of God!!

Oestrogens & VTE:-- Estrogen cause slight increase in fibrinogen and by that promotes slightly  Of the contraceptive steroids we should remember that it is the estrogen which causes hypercoagulable state and is primarily attributed for DVT and allied thrombosis during OCP intake. The risk of VTE is directly related to dose of E but the OCP induced risk of VTE IN PREGNANCY IS LOWER THAN THE RSIK ASSOCIATED WIRH EVEN LOW-DOSE COC.

Inherited Thrombophilia:-  But as we know in some countries factor Leiden mutation, Protein-C /S synthesis disorders (DEFICIENT PRODUCTION) or prothrombin mutation disorders are to the extent of 0.5 to 5% of general population in those countries. In such countries it will be prudent to screen women who candidates for inherited thrombophilias and refrain from prescribing OCP if screen +ve or family is +ve/ or she herself has already suffered from DVT in the recent past.. This is not true for our country.

Acquired APC resistance:-  APC resistance :- APC naturally down regulates the thrombin formation. APC therefore is a naturally occurring the prevalence of DVT in acquired APC resistance is 6/10,000 women in reproductive years. Who are not.OCP? But if one uses OVP then the prevalence goes up to Increased APC resistance can invite thrombosis.

PCOS & Venous thrombosis:- using Thrombosis can occur at varying sites including legs, thigh veins, lungs,