Effects of estrogens and progestagens on the primary variables of haemostasis
Keywords:
Estrogens, Progestagens, Blood coagulation, Factor VIII, Factor VAbstract
Background: The present study aims at determining the effect of two combined oral contraceptives on the primary variables of haemostasis in a group of healthy Albanian women.
Methods: In this study were included, 49 women between the ages of 24 and 51 years, twenty nine of them taking ethinylestradiol 30 μg and gestodene 75 μg and twenty of them taking ethinylestradiol 30 μg and levonorgestrel 75 μg for 1-2 months. The subjects had no history of thromboembolic disease. Plasma was used for measuring levels of PT, fibrinogen, factors V and VIII, before and after pill use. Collected data were analyzed using SPSS 20 software.
Results: Comparison of values of the parameters before and after treatment showed that concentrations of fibrinogen and factor VIII were significantly increased following treatment (p<0.05), while we noted no significant changes in the level of factor V. Prothrombin time and activated thromboplastin time were reduced during treatment (p>0.05).
Conclusions: The results show that changes in the haemostatic primary variables after combined oral contraceptive administration are significant which might increase the risk for thrombotic situations.
References
World Health Organization. Cardiovascular Disease and Steroid Hormone Contraception. Report of a WHO Scientific group. WHO Technical Report, 1998. Series 877. Geneva: World Health Organization.
Lemaitre RN, Heckbert SR, Psaty BM, Smith NL, Kaplan RC, Longstreth WT Jr. Hormone replacement therapy and associated risk of stroke in postmenopausal women. Archives of Internal Medicine 2002;162: 1954–1960.
Jordan WM. 1961. Pulmonary embolism. Lancet ii, 1146–1147.
Jick SS, Jick H. The contraceptive patch in relation to ischemic stroke and acute myocardial infarction. Pharmacotherapy 2007;27(2): 218-20.
Rossouw JE, Anderson GL, Prentice RL, Lacroix AZ, Kooperberg C,Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J. Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. Journal of the American Medical Association 2002;288:321-33.
World Health Organization. Scientific group meeting on cardiovascular disease and steroid hormone contraceptives. Weekly Epidemiological Record 1995;72:361-3.
Baillargeon JP, McClish DK, Essah PA, Nestler JE. Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. The Journal of Clinical Endocrinology & Metabolism 2005;90:3863-70.
van Hylckama Vlieg A, Helmerhorst FM, Vandenbroucke JP, Doggen CJ, Rosendaal FR. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case–control study. British Medical Journal 2009;339: b2921, http://dx.doi.org/10.1136/bmj.b2921.
Parkin L, Sharples K, Hernandez RK, Jick SS. Risk of venous thromboembolism in users of oral contraceptives containing drospirenone or levonorgestrel: nested case–control study based on UK General Practice Research Database. British Medical Journal, 2011:342: d2139, http://dx.doi.org/10.1136/bmj.d2139.
Lidegaard O, Lokkegaard E, Svendsen AL, Agger C. Hormonal contraception and risk of venous thromboembolism: national follow-up study. British Medical Journal 2009:339: 2890. http://dx.doi.org/10.1136/bmj.b28.
Prasad RNV, Koh SCL, Osborn AC, Viegas MD, Shan Ratnam S. Effect on hemostasis after two-year use of low dose combined oral contraceptives with gestodene or levonorgestrel. Clinical and Applied Thrombosis/Hemostasis 1999:60-70.
Jick SS, Hagberg KW, Hernandez RK, Kaye JA. Postmarketing study of ORTHO EVRA and levonorgestrel oral contraceptives containing hormonal contraceptives with 30 mcg of ethinyl estradiol in relation to nonfatal venous thromboembolism. Contraception 2010;81:16-21.
Gronich N, Lavi I, Rennert G. Higher risk of venous thrombosis associated with drospirenone-containing oral contraceptives: a population-based study. Canadian Medical Association Journal 2011;183:319-25.
Jick SS, Hernandez RK. Risk of non-fatal venous thromboembolism in women using oral contraceptives containing drospirenone compared with women using oral contraceptives containing levonorgestrel: case–control study using United States claims data. British Medical Journal 2011; 342: d2151, http://dx.doi.org/10.1136/bmj.d2151.
