Contraception in Myeloproliferative Neoplasms: A Pharmacological Review.

Myeloproliferative neoplasms (MPNs) are chronic hematologic disorders characterized by clonal proliferation of myeloid lineage cells, commonly driven by JAK2 mutations, and associated with significant thrombotic and hemorrhagic complications. Women of reproductive age with MPNs face unique challenges in selecting safe and effective contraception, as these disorders inherently increase thrombotic risk and may interact with hormonal contraceptive therapies. Estrogen-containing contraceptives are contraindicated due to their association with venous and arterial thrombosis, while progestin-only and non-hormonal methods are generally safer but must be tailored to individual risks such as thrombocytopenia, prior thrombotic events, and disease-modifying therapies. This review provides a comprehensive analysis of contraceptive options for women with MPNs, exploring the thrombotic and bleeding risks associated with different methods and the potential impact of MPN treatments, including JAK2 inhibitors, on contraceptive efficacy. By synthesizing current evidence, the review aims to guide clinicians in optimizing reproductive health for women with MPNs while minimizing the risks of their underlying hematologic condition.