Background: No clear guideline exists for the management of female hormone therapy
in the perioperative period. Besides oral contraceptives (OCPs), hormone medications have been
prescribed to treat cancer, osteoporosis, and menopausal symptoms. Since the introduction of OCPs
in the 1960s, the thromboembolic risk associated with these medications has been studied and alterations
have been made in the hormone content. The continuation of hormone therapy in the perioperative
period and its possible interactions with commonly used anesthetic agents are important
information for all perioperative health care providers.
Objective: A review was done on the current guideline and available literature for the mechanisms
of action and perioperative management of OCPs, hormone replacement therapy (HRT), and antineoplastic
Method: Available guidelines and literature were reviewed and summarized.
Results: Based on the available literature, no definite guidelines have been established for perioperative
management of OCPs and HRT. However, manufacturers have recommended that these
medications should be held perioperatively. Other antineoplastic hormonal modulators have increased
the risk of venous thromboembolism and have perioperative implications that should be
discussed with the prescribing physicians and addressed with the patient.
Conclusion: Until additional studies are performed, the risks and benefits must be weighed on an
individual basis with consideration of prophylaxis when a decision is made to continue these medications
in the perioperative period. Part of this decision making includes the risk of fetal harm in an
unwanted pregnancy in preparation for nonobstetric surgery versus an increased risk of venous