{"id":61733,"date":"2026-04-17T08:58:38","date_gmt":"2026-04-17T07:58:38","guid":{"rendered":"https:\/\/www.mediconanet.pt\/?p=61733"},"modified":"2026-04-17T16:32:34","modified_gmt":"2026-04-17T15:32:34","slug":"pilula-risco-trombose-o-que-deve-saber","status":"publish","type":"post","link":"https:\/\/www.mediconanet.pt\/en\/pilula-risco-trombose-o-que-deve-saber\/","title":{"rendered":"P\u00edlula Contraceptiva e Risco de Trombose: O Que a Ci\u00eancia Diz"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"61733\" class=\"elementor elementor-61733\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-570cfe3 e-flex e-con-boxed e-con e-parent\" data-id=\"570cfe3\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1761780 elementor-widget elementor-widget-text-editor\" data-id=\"1761780\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Introdu\u00e7\u00e3o<\/h2><p>O risco de tromboembolismo venoso (TEV) \u00e9 uma das preocupa\u00e7\u00f5es mais frequentes das mulheres que usam ou ponderam usar a <b>p\u00edlula <\/b>combinada. \u00c9 importante compreender a dimens\u00e3o real deste risco e os fatores que o modulam.<\/p><h2>Os n\u00fameros em contexto<\/h2><p>O risco basal de TEV em mulheres jovens n\u00e3o utilizadoras \u00e9 de cerca de 2 por 10\u202f000 mulheres-ano. Com <b>p\u00edlula<\/b> combinada de 2.\u00aa gera\u00e7\u00e3o (levonorgestrel), sobe para 5-7 por 10\u202f000; com progestativos de 3.\u00aa e 4.\u00aa gera\u00e7\u00e3o (desogestrel, gestodeno, drospirenona), para 9-12 por 10\u202f000. Para compara\u00e7\u00e3o, na gravidez o risco \u00e9 de cerca de 29 por 10\u202f000. Ou seja, o risco absoluto \u00e9 baixo, mas \u00e9 real.<\/p><h2>Fatores que aumentam o risco<\/h2><p>Tabagismo (especialmente ap\u00f3s os 35 anos), obesidade, imobiliza\u00e7\u00e3o prolongada, cirurgia recente, hist\u00f3ria pessoal ou familiar de TEV e trombofilias heredit\u00e1rias (fator V de Leiden, muta\u00e7\u00e3o da protrombina) s\u00e3o os fatores de risco mais relevantes. Em mulheres com estes fatores, a\u00a0<a href=\"https:\/\/www.mediconanet.pt\/produto\/contracepcao\/\" target=\"_blank\" rel=\"noopener\"><b>p\u00edlula\u00a0<\/b><\/a>combinada pode estar contraindicada.<\/p><h2>Primeira prescri\u00e7\u00e3o e escolha<\/h2><p>As guidelines (FSRH, NICE, OMS) recomendam que, na primeira prescri\u00e7\u00e3o, se opte por p\u00edlulas com levonorgestrel ou noretisterona associados a etinilestradiol em dose baixa (20-30 \u00b5g), por terem menor risco tromboemb\u00f3lico. O rastreio universal de trombofilias n\u00e3o \u00e9 custo-efetivo nem recomendado; a hist\u00f3ria cl\u00ednica cuidadosa \u00e9 o instrumento fundamental.<\/p><h2>P\u00edlula s\u00f3 com progestativo<\/h2><p>As p\u00edlulas s\u00f3 com progestativo (desogestrel, drospirenona) n\u00e3o est\u00e3o associadas a aumento do risco de TEV e s\u00e3o alternativa segura para mulheres com contraindica\u00e7\u00e3o a estrog\u00e9nios.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1545e08 e-flex e-con-boxed e-con e-parent\" data-id=\"1545e08\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8ee3907 elementor-widget elementor-widget-image\" data-id=\"8ee3907\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"450\" src=\"https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/04\/Imagem-para-Redes-Sociais-a-Rosa-sobre-Descontos-de-Primavera-2026-04-17T124143.878-1024x576.jpg\" class=\"attachment-large size-large wp-image-61837\" alt=\"Mulher em consulta online para esclarecimento sobre a p\u00edlula\" srcset=\"https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/04\/Imagem-para-Redes-Sociais-a-Rosa-sobre-Descontos-de-Primavera-2026-04-17T124143.878-1024x576.jpg 1024w, https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/04\/Imagem-para-Redes-Sociais-a-Rosa-sobre-Descontos-de-Primavera-2026-04-17T124143.878-300x169.jpg 300w, https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/04\/Imagem-para-Redes-Sociais-a-Rosa-sobre-Descontos-de-Primavera-2026-04-17T124143.878-768x432.jpg 768w, https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/04\/Imagem-para-Redes-Sociais-a-Rosa-sobre-Descontos-de-Primavera-2026-04-17T124143.878-18x10.jpg 18w, https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/04\/Imagem-para-Redes-Sociais-a-Rosa-sobre-Descontos-de-Primavera-2026-04-17T124143.878-600x337.jpg 600w, https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/04\/Imagem-para-Redes-Sociais-a-Rosa-sobre-Descontos-de-Primavera-2026-04-17T124143.878.jpg 1366w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9ad30cf e-con-full e-flex e-con e-child\" data-id=\"9ad30cf\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-66e4f21 e-con-full e-flex e-con e-child\" data-id=\"66e4f21\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c44ae3e elementor-widget elementor-widget-heading\" data-id=\"c44ae3e\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Perguntas frequentes (FAQ)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-439b5c3 elementor-widget elementor-widget-n-accordion\" data-id=\"439b5c3\" data-element_type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7080\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7080\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Devo fazer an\u00e1lises antes de come\u00e7ar a p\u00edlula? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7080\" class=\"elementor-element elementor-element-d801294 e-con-full e-flex e-con e-child\" data-id=\"d801294\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7080\" class=\"elementor-element elementor-element-67dd609 e-flex e-con-boxed e-con e-child\" data-id=\"67dd609\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2204be5 elementor-widget elementor-widget-text-editor\" data-id=\"2204be5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>An\u00e1lises de sangue ou rastreio de trombofilias n\u00e3o s\u00e3o necess\u00e1rios por rotina. A avalia\u00e7\u00e3o assenta na hist\u00f3ria cl\u00ednica e familiar.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7081\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7081\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Posso tomar a p\u00edlula se fumar? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7081\" class=\"elementor-element elementor-element-f07e3ff e-con-full e-flex e-con e-child\" data-id=\"f07e3ff\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7081\" class=\"elementor-element elementor-element-ba0d7df e-flex e-con-boxed e-con e-child\" data-id=\"ba0d7df\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bd0918d elementor-widget elementor-widget-text-editor\" data-id=\"bd0918d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ap\u00f3s os 35 anos, a <b>p\u00edlula <\/b>combinada \u00e9 contraindicada em fumadoras. Abaixo dessa idade, fumar ainda aumenta o risco e a cessa\u00e7\u00e3o tab\u00e1gica \u00e9 fortemente recomendada.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7082\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7082\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> E nas viagens longas de avi\u00e3o? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7082\" class=\"elementor-element elementor-element-1948aa2 e-con-full e-flex e-con e-child\" data-id=\"1948aa2\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7082\" class=\"elementor-element elementor-element-44203e4 e-flex e-con-boxed e-con e-child\" data-id=\"44203e4\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-90363e4 elementor-widget elementor-widget-text-editor\" data-id=\"90363e4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>O risco de trombose em voos longos (+4h) \u00e9 baixo. Hidrate-se, mova-se regularmente e considere meias de compress\u00e3o se tiver fatores de risco adicionais.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<script type=\"application\/ld+json\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@type\":\"FAQPage\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"Devo fazer an\\u00e1lises antes de come\\u00e7ar a p\\u00edlula?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"An\\u00e1lises de sangue ou rastreio de trombofilias n\\u00e3o s\\u00e3o necess\\u00e1rios por rotina. A avalia\\u00e7\\u00e3o assenta na hist\\u00f3ria cl\\u00ednica e familiar.\"}},{\"@type\":\"Question\",\"name\":\"Posso tomar a p\\u00edlula se fumar?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Ap\\u00f3s os 35 anos, a p\\u00edlula combinada \\u00e9 contraindicada em fumadoras. Abaixo dessa idade, fumar ainda aumenta o risco e a cessa\\u00e7\\u00e3o tab\\u00e1gica \\u00e9 fortemente recomendada.\"}},{\"@type\":\"Question\",\"name\":\"E nas viagens longas de avi\\u00e3o?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"O risco de trombose em voos longos (+4h) \\u00e9 baixo. Hidrate-se, mova-se regularmente e considere meias de compress\\u00e3o se tiver fatores de risco adicionais.\"}}]}<\/script>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-02d7fba e-flex e-con-boxed e-con e-parent\" data-id=\"02d7fba\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ca91313 elementor-widget elementor-widget-text-editor\" data-id=\"ca91313\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2>Refer\u00eancias<\/h2><p><a href=\"https:\/\/www.dgs.pt\/\" target=\"_blank\" rel=\"dofollow noopener\">DGS \u2013 Sa\u00fade Reprodutiva: Planeamento Familiar<\/a><\/p><p><a href=\"https:\/\/www.fsrh.org\/\" target=\"_blank\" rel=\"dofollow noopener\">FSRH \u2013 Combined Hormonal Contraception Guideline<\/a><\/p><p><a href=\"https:\/\/cks.nice.org.uk\/\" target=\"_blank\" rel=\"dofollow noopener\">NICE CKS \u2013 Contraception \u2013 combined hormonal methods<\/a><\/p><p><a href=\"https:\/\/www.who.int\/\" target=\"_blank\" rel=\"dofollow noopener\">WHO \u2013 Medical Eligibility Criteria for Contraceptive Use<\/a><\/p><p><a href=\"https:\/\/www.cdc.gov\/\" target=\"_blank\" rel=\"dofollow noopener\">CDC \u2013 Contraceptive Use Guidelines<\/a><\/p><p><a href=\"https:\/\/www.acog.org\/\" target=\"_blank\" rel=\"dofollow noopener\">ACOG \u2013 Combined Hormonal Birth Control<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Introdu\u00e7\u00e3o O risco de tromboembolismo venoso (TEV) \u00e9 uma das preocupa\u00e7\u00f5es mais frequentes das mulheres que usam ou ponderam usar a p\u00edlula combinada. \u00c9 importante compreender a dimens\u00e3o real deste risco e os fatores que o modulam. Os n\u00fameros em contexto O risco basal de TEV em mulheres jovens n\u00e3o utilizadoras \u00e9 de cerca de [&hellip;]<\/p>\n","protected":false},"author":13102,"featured_media":61841,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[267],"tags":[],"class_list":["post-61733","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-contracecao"],"jetpack_featured_media_url":"https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/04\/Imagem-para-Redes-Sociais-a-Rosa-sobre-Descontos-de-Primavera-2026-04-17T121623.193.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/61733","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/users\/13102"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/comments?post=61733"}],"version-history":[{"count":7,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/61733\/revisions"}],"predecessor-version":[{"id":61840,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/61733\/revisions\/61840"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/media\/61841"}],"wp:attachment":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/media?parent=61733"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/categories?post=61733"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/tags?post=61733"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}