title: Hormone replacement therapy and hemostasis: effects in Brazilian postmenopausal women.
abstract: OBJECTIVE
  To evaluate the impact that administration of transdermal estradiol gel combined with medroxyprogesterone acetate (MPA) has on hemostasis.
  
  
  METHODS
  In this open prospective longitudinal study, thirty postmenopausal women received transdermal estradiol gel (1 mg/day) continuously combined with oral MPA (5 mg/day) for 12 days/month. The following parameters were determined: prothrombin time (PT), activated partial thromboplastin time (aPTT), factors VII, X, and XII activity, fibrinogen levels, thrombin-antithrombin complex levels, protein C and S antigen, antithrombin activity, plasminogen activator inhibitor type 1 (PAI-1) antigen, tissue-type plasminogen activator (t-PA) antigen, plasminogen activity and fibrin degradation products (FbDP) antigen. They were evaluated before and after 6 months of treatment.
  
  
  RESULTS
  There was a significant decrease in factor VII activity (P=0.001), factor X activity (P=0.016), protein C antigen (P=0.022), antithrombin activity (P=0.025), plasminogen activity (P=0.023), t-PA antigen (P=0.043) and FbDP antigen (P=0.048) compared with baseline values.
  
  
  CONCLUSIONS
  The results suggest that the treatment with transdermal estradiol gel combined with MPA avoids any major activation of coagulation and does not produce any overall effect on fibrinolysis. Therefore, this treatment might provide interesting effects on hemostasis in postmenopausal Brazilian women.
authors.affiliation: Department of Clinical, Toxicological and Bromatological Analyses, School of Pharmaceutical Sciences of Ribeirão Preto (FCFRP), University of São Paulo, São Paulo, Brazil.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Callejon
authors.forename: Silvio A
authors.initials: SA
authors.lastname: Franceschini
authors.forename: Marlise B A
authors.initials: MB
authors.lastname: Montes
authors.forename: Maria R T
authors.initials: MR
authors.lastname: Toloi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001779:Blood Coagulation Factors / Q000032:analysis; D001938:Brazil; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D006487:Hemostasis / Q000187:drug effects*; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D017698:Postmenopause / Q000097:blood* / Q000187:drug effects; D011446:Prospective Studies; D011517:Prothrombin Time; D016896:Treatment Outcome
chemical_list: D001779:Blood Coagulation Factors; D003271:Contraceptive Agents, Female; D004958:Estradiol; D005340:Fibrinogen; D017258:Medroxyprogesterone Acetate