Intimate partner violence as a risk factor for venous thromboembolism in women on combined oral contraceptives: An international matched case-control study

Strategies, costs and counter-strategies to sexual coercion

Sexual conflict, the conflict between the evolutionary interests of females and males over mating, occasionally results in the evolution of traits favourable for one sex and adverse for the other. In this context, males can use sexual coercion to increase their mating success, at the expense of their female targets' mate choice. An increasing number of studies highlight a great diversity of male and female behaviours that serve as strategies and counter-strategies, respectively, to sexual coercion. Previous studies have reviewed the literature on infanticide but not the literature on forced copulation, sexual harassment, intimidation or punishment. This qualitative review synthesises the empirical evidence and draws a unified framework of the ecology of sexual coercion across animals, presenting male sexually coercive strategies and co-evolved female counter-strategies that can reduce coercion and its fitness costs. Using examples from insects to humans, it shows that different strategies of sexual coercion can lead to the evolution of similar counter-strategies. These counter-strategies include female promiscuity, deception of males (e.g. concealed ovulation or pseudo-oestrus), avoidance of certain males and association with others for protection, female aggregation to dilute coercion and ultimately physical resistance by single or allied females. Extending previous work, this review provides compelling evidence of sexually antagonistic coevolution amid sexual coercion. It also calls for future work to clarify, first, which individual traits are linked to greater coercion rates in males and a higher likelihood of receiving coercion in females and, second, any causal relationships between different strategies of sexual coercion and the evolution of different social and mating systems.

Venous Thromboembolism at Low Risk of Recurrence in Young Women: Stress and Violence Associated with Recurrence. An International Case-Control Study

BACKGROUND

 In young women with venous thromboembolism (VTE) related to weak transient risk factors, it remains unknown whether stress levels and intimate partner violence (IPV) are associated with recurrence. The VTE-WEAK study aims to investigate the association between perceived stress and IPV with a recurrence of VTE in women with a first episode of VTE due to combined oral contraceptives, pregnancy-puerperium, minor trauma/fracture, brief surgery, infection or brief immobility, and not using antithrombotic prophylaxis.

MATERIAL AND METHODS

 We performed a multicenter, international, observational, retrospective study on women referred for thrombophilia screening who were subsequently monitored. Patients were aged 18 to 55 years old and free of high-risk thrombophilia. When a recurrence of VTE was suspected for the first time, the perceived stress level and IPV were evaluated using self-administrated PSS-10 and Woman Abuse Screening Tool (WAST) questionnaires.

RESULTS

 We monitored 7,754 women over 43,880 patients-years. A first suspected recurrence occurred in 4,772 women, among whom 1,316 had an objectively confirmed recurrence. The perceived stress level and an IPV situation were both independent risk factors for recurrence: moderate stress: adjusted odds ratio (aOR) 1.630 (1.415-2.468); high perceived stress: aOR 10.03 (7.528-13.36); IPV: 1.953 (1.546-2.468), p < 0.0001.

CONCLUSION

 The perceived level of stress and IPV are associated with a recurrence of VTE when suspected. The mechanisms and clinical consequences of a possible stress coagulopathy require investigation.