title: Effect of pulsed estrogen therapy on hemostatic markers in comparison with oral estrogen regimen in postmenopausal women.
abstract: OBJECTIVE
  Hormone replacement therapy (HRT) is associated with an increased risk of thromboembolism dependent on the type of HRT; therefore, we compared therapy effects of intranasal with oral estrogens on coagulation and fibrinolysis markers in postmenopausal women.
  
  
  METHODS
  A randomized study in which 29 healthy hysterectomized women received intranasal 17beta-estradiol or oral estrogens for 3 months.
  
  
  RESULTS
  There were no significant differences in the baseline characteristics between groups. Those women receiving intranasal estradiol showed a mild increment in plasminogen activator inhibitor-1 (PAI-I) (from 6.8 +/- 3.5 to 9.6 +/- 3.9 U/ml, p < 0.01); however, fibrinogen, factor VII-tissue factor complex (VIIa-rTF), antithrombin III (ATIII), protein C (PC) activity, protein S (PS) activity, plasminogen (PLG), and tissue-type plasminogen activator antigen (t-PA) were unchanged. In contrast, oral unopposed estrogens elevated t-PA (from 4.9 +/- 2.9 to 9.6 +/- 5.1 ng/ml, p < 0.01) in parallel with a decrement in PAI-I (from 5.2 +/- 4.0 to 2.7 +/- 1.7 U/ml, p < 0.05) and VIIa-rTF (from 201.2 +/- 181.0 to 140.6 +/- 108.7 mU/ml, p < 0.05). Fibrinogen, ATIII, PC, PS, and PLG were unchanged.
  
  
  CONCLUSIONS
  Nasal 17beta-estradiol had no effect on the coagulation markers, except a moderate increment in PAI-1. In contrast, oral estrogens elicited a decrement in both VIIa-rTF and PAI-1; however, those changes did not surpass normal limits.
authors.affiliation: Endocrine Research Unit, Nacional Medical Center, Instituto Mexicano del Seguro Social, México City, Mexico.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Basurto
authors.forename: Renata
authors.initials: R
authors.lastname: Saucedo
authors.forename: Arturo
authors.initials: A
authors.lastname: Zárate
authors.forename: Carlos
authors.initials: C
authors.lastname: Martínez
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gaminio
authors.forename: Elba
authors.initials: E
authors.lastname: Reyes
authors.forename: Marcelino
authors.initials: M
authors.lastname: Hernandez
mesh_terms: D000281:Administration, Intranasal; D000284:Administration, Oral; D001777:Blood Coagulation / Q000187:drug effects*; D001779:Blood Coagulation Factors / Q000032:analysis* / Q000187:drug effects; D004958:Estradiol / Q000008:administration & dosage* / Q000494:pharmacology; D015914:Estrogen Replacement Therapy; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D017698:Postmenopause; D010959:Tissue Plasminogen Activator / Q000097:blood / Q000187:drug effects
chemical_list: D001779:Blood Coagulation Factors; D017395:Plasminogen Activator Inhibitor 1; D004958:Estradiol; D010959:Tissue Plasminogen Activator