Pille und Schlaganfall – Offensichtlich keine zusätzliche Gefahr durch die Einnahme

Die medizinische Wissenschaft folgt stets den wissenschaftlich und statistisch belegbaren evidenten Ergebnissen und Wahrheiten.

Diese können je nach Blickwinkel und Auswahl sich im Wandel der Jahrzehnte einmal als positiv und dann wiederum als negativ erweisen.

Die Einnahme von Hormonpräparaten zur Antikonzeption galt bisher aufgrund seiner thrombogenen Wirkung als zusätzlicher Risikofaktor für pathologische Gefäßereignisse (zum Beispiel dem Schlaganfall).

Dem scheint nicht so zu sein, wie der folgende Artikel berichtet.

„Zitat“

 

Gemeinsame Presseinformation der Deutschen Schlaganfall-Gesellschaft (DSG) und der Deutschen Gesellschaft für Neurologie (DGN)Schlaganfall und Herzinfarkt durch Pille & Co? Fachgesellschaften schätzen Risiko gering einBerlin, 23. Juli 2012 – Weibliche Geschlechtshormone in Antibabypille, Verhütungs- pflaster oder Vaginalring können die Blutgerinnung beeinflussen und – in seltenen Fällen – zu Blutgerinnseln führen. Die Folge können tiefe Beinvenenthrombosen, Lungenembolien, Herzinfarkt oder Schlaganfall sein. Eine aktuelle dänische Studie hat nun das Risiko für Schlaganfall und Herzinfarkt über einen Zeitraum von 15 Jahren bei insgesamt mehr als 1,6 Millionen Frauen untersucht. Die Gefahr für die einzelne Frau ist nach Einschätzung der Deutschen Schlaganfall-Gesellschaft (DSG) und der Deutschen Gesellschaft für Neurologie (DGN) jedoch sehr gering und lässt sich durch Vorsichtsmaßnahmen zusätzlich vermindern.Pressemitteilung zum Download„Das Thrombose-Risiko für tiefe Beinvenenthrombosen und Lungenembolien von hormonellen Verhütungsmitteln ist seit Langem bekannt“, erläutert Professor Dr. med. Matthias Endres, 1. Vorsitzender der DSG und Direktor der Klinik für Neurologie an der Berliner Charité: „Das ist ein Grund, warum die Antibabypille auch 50 Jahre nach ihrer Einführung weiterhin verschreibungspflichtig ist.“ Bevor Frauenärzte ein Rezept ausstellen, müssen sie das individuelle Risiko ihrer Patientin sorgfältig abschätzen. „Eine bekannte Thrombose-Neigung oder starkes Übergewicht sind oft ein Grund, auf andere wirksame Verhütungsmethoden zu wechseln“, sagt Professor Endres.

Das Thrombose-Risiko in den Venen ist gut untersucht: Im schlimmsten Fall kann es zu einer Lungenembolie führen. Doch zum Herzinfarkt- und Schlaganfall-Risiko gab es nach Auskunft von Professor Endres bislang kaum zuverlässige Zahlen. Dies ändert eine Untersuchung aus Dänemark: Sie liefert nach Einschätzung des Berliner Experten eine sichere Grundlage für die ärztliche Beratung. Die Kopenhagener Forscher haben darin sämtliche Verordnungen hormoneller Verhütungsmittel über einen Zeitraum von 15 Jahren mit Krankenhausbehandlungen wegen Schlaganfall und Herzinfarkt in Beziehung gesetzt. „Die Untersuchung belegt, dass ein minimales Risiko vorhanden ist“, stellt der Experte fest. „Es ist aber deutlich geringer als das Risiko einer venösen Thrombose.“

Persönliches Risiko der einzelnen Anwenderin ist gering

Nach den Berechnungen der dänischen Forscher komme es im Durchschnitt pro Jahr bei 6,8 von 10 000 Frauen, die eine der heute üblichen Methoden hormoneller Empfängnisverhütung anwenden, zu einer venösen Thrombose. Zudem würden zwei Frauen von 10 000 pro Jahr einen Herzinfarkt oder Schlaganfall erleiden, wobei das Risiko je nach Art und Dosis der Hormone variieren kann. „Bei der Antibabypille spielt die Dosis der Östrogene und die Wahl des Gestagens eine Rolle“, erläutert Professor Dr. med. Hans-Christoph Diener, Sprecher der Deutschen Gesellschaft für Neurologie und Direktor der Klinik für Neurologie am Universitätsklinikum in Essen. Auch Verhütungspflaster oder Vaginalring waren in der Studie mit einem minimal erhöhten Risiko behaftet. Für die Spirale – in der Variante, die Hormone freisetzt – ergab sich dagegen kein erhöhtes Risiko. Für die Beratung der Frauen seien dies sicherlich wichtige Informationen, so Professor Diener, der insgesamt keinen Grund zu großer Sorge sieht. „Hormonpräparate dürfen jedoch niemals unbedacht eingesetzt werden“, mahnt der Experte aus Essen: „Im Zweifelsfall sollten sich Frauen ärztlich beraten lassen und auf andere, ebenfalls sichere Verhütungsmittel zurückgreifen.“


Literatur

Lidegaard Ø, Løkkegaard E, Jensen A, Skovlund CW, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. New England Journal of Medicine 2012; 366: 2257-66


Fachliche Kontakte

Prof. Dr. med. Matthias Endres
1. Vorsitzender der Deutschen Schlaganfall-Gesellschaft (DSG)
Direktor der Klinik für Neurologie
Ärztlicher Centrumsleiter, Charité Centrum 15 für Neurologie, Neurochirurgie und Psychiatrie
Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin
Tel.: +49 (0)30 450560-102, Fax: +49 (0)30 450560-932
E-Mail: matthias.endres@charite.de Diese E-Mail-Adresse ist gegen Spambots geschützt! JavaScript muss aktiviert werden, damit sie angezeigt werden kann.

Prof. Dr. med. Hans-Christoph Diener
Deutsche Gesellschaft für Neurologie (DGN)
Direktor der Klinik für Neurologie am Universitätsklinikum Essen
Hufelandstr. 55, 45122 Essen
Tel.: +49 (0)201 7232460, Fax: +49 (0)201 7235901
E-Mail: hans.diener@uk-essen.de Diese E-Mail-Adresse ist gegen Spambots geschützt! JavaScript muss aktiviert werden, damit sie angezeigt werden kann.

Pressestelle der Deutschen Schlaganfall-Gesellschaft
Tel.: +49 (0)711 8931-380
Fax: +49 (0)711 8931-167
E-Mail: arnold@medizinkommunikation.org Diese E-Mail-Adresse ist gegen Spambots geschützt! JavaScript muss aktiviert werden, damit sie angezeigt werden kann.

Pressestelle der Deutschen Gesellschaft für Neurologie e.V.
Tel.: +49 (0)89 461486 22
Fax: +49 (0)89 461486 25
E-Mail: presse@dgn.org Diese E-Mail-Adresse ist gegen Spambots geschützt! JavaScript muss aktiviert werden, damit sie angezeigt werden kann.

Die Deutsche Gesellschaft für Neurologie e.V. (DGN)
sieht sich als neurologische Fachgesellschaft in der gesellschaftlichen Verantwortung, mit ihren rund 7000 Mitgliedern die neurologische Krankenversorgung in Deutschland zu verbessern. Dafür fördert die DGN Wissenschaft und Forschung sowie Lehre, Fort- und Weiterbildung in der Neurologie. Sie beteiligt sich an der gesundheitspolitischen Diskussion. Die DGN wurde im Jahr 1907 in Dresden gegründet. Sitz der Geschäftsstelle ist die Bundeshauptstadt Berlin.  www.dgn.org1. Vorsitzender: Prof. Dr. med. Wolfgang Oertel
2. Vorsitzender: Prof. Dr. med. Heinz Reichmann
3. Vorsitzender: Prof. Dr. med. Martin Grond
Geschäftsführer: Dr. rer. nat. Thomas ThiekötterGeschäftsstelle
Reinhardtstr. 14, 10117 Berlin, Tel: +49 (0)30-531437930, E-Mail: info@dgn.orgDiese E-Mail-Adresse ist gegen Spambots geschützt! JavaScript muss aktiviert werden, damit sie angezeigt werden kann.Ansprechpartner für die Medien
Frank A. Miltner, Tel: +49 (0)89-461486-22, E-Mail: presse@dgn.orgDiese E-Mail-Adresse ist gegen Spambots geschützt! JavaScript muss aktiviert werden, damit sie angezeigt werden kann.Pressesprecher der DGN: Prof. Dr. med. Hans-Christoph Diener, Essen

 

 

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