Changes in hemostatic parameters after oral hormone therapy in postmenopausal women.
OBJECTIVE
Oral hormone therapy (HT) and menopausal age are both prothrombotic risk factors. The aim of our study was to compare the hemostatic parameters in plasma of postmenopausal women after 6 months of oral HT with parameters of control (without treatment) postmenopausal women.


METHODS
Twenty-seven postmenopausal women were treated with 17β-estradiol (1 mg) and dydrogesterone (5 mg) daily for 6 months. The control group (27 women) did not receive any HT. Hemostatic factors, such as fibrinogen (FG) concentration, activated partial thromboplastin time (APTT), platelet (PLT) count, maximum velocity of clot formation, and fibrin lysis half-time were estimated.


RESULTS
The hemostatic parameters in both groups differ significantly. After 6 months oral HT, APTT and the level of FG were higher than in the control group (APTT 30.08 seconds vs. 28.18 seconds, p = 0.02; FG 4.14 g/L vs. 3.03 g/L, p < 0.001). However, the higher values of maximal velocity of FG polymerization (153.53 mOD/min vs. 92.87 mOD/min, p < 0.001), maximum absorbance values (0.306 vs. 0.275, p < 0.001), and fibrin lysis half-time (32.33 minutes vs. 18.11 minutes, p < 0.001) compared with values in the control group also were observed. There was no statistically significant difference in PLT counts between control and women treated with oral HT.


CONCLUSIONS
Six months of oral combined HT (17β-estradiol and dydrogesterone) caused increased initial velocity of clot formation and inhibition of fibrinolysis. The increased level of FG and its higher polymerization may help explain the increase in venous thrombosis and cardiovascular events reported after the use of oral HT.
Department of General Biochemistry, University of Lodz, Lodz, Poland. martabor@biol.uni.lodz.pl
Marta
M
Borowiecka
Ireneusz
I
Polac
Pawel
P
Nowak
Pawel
P
Radwan
Michal B
MB
Ponczek
Barbara
B
Wachowicz
D016022:Case-Control Studies; D004394:Dydrogesterone / Q000008:administration & dosage; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy / Q000379:methods*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis / Q000502:physiology; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D017698:Postmenopause / Q000097:blood*; D011516:Prothrombin / Q000032:analysis; D011517:Prothrombin Time; D012307:Risk Factors; D019851:Thrombophilia / Q000175:diagnosis* / Q000188:drug therapy
D004958:Estradiol; D011516:Prothrombin; D005340:Fibrinogen; D004394:Dydrogesterone