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Female sexual steroids strongly influence different steps of coagulation. This explains why women's health during different life spans is affected significantly by thrombophilias. The aim of this review article is to summarize current knowledge on thrombophilias regarding oral contraception (OC) and hormonal replacement therapy (HRT).More than a hundred million women worldwide use female sexual steroids as OC or HRT. The understanding of acquired and inherited thrombophilias has increased dramatically over the last two decades.At present, it is not recommended that all OC or HRT users should be routinely screened for acquired or inherited thrombophilias. The usefulness of testing for these disorders in the presence of multiple thrombotic risk factors should be considered on an individual basis.