title: Comparison of the impact of four generations of progestins on hemostatic variables.
abstract: This study was undertaken to evaluate the impact of progestins as part of low-estrogen (ethinyl estradiol [EE2] ≤35 μg) combined oral contraceptives (COCs) on hemostatic variables. One hundred ninety-five healthy women took oral contraceptives with following formulations: 35 EE2/norgestimate (NGM), 35 EE2/cyproterone acetate, 35 EE2/norethisterone, 30 EE2/levonorgestrel, 30 EE2/drospirenone (DRSP), 20 EE2/gestodene, and 20 EE2/DRSP, for 6 months. Hemostatic assays (prothrombin time, activated partial thromboplastin time, fibrinogen, resistance to activated protein C ratio, protein C, protein S, factor VIII [FVIII], antithrombin, plasminogen, α2-antiplasmin, inhibitor of plasminogen activator type 1 [PAI-1] and d-dimers) were performed in 3 time points: at baseline, after 3, and 6 cycles. For each formulation, results were compared according to baseline values, intergroup analysis, and the amount of estrogen or progestin component. Most of the variables were changed except FVIII. Significant difference between oral contraceptives was found in antithrombin, protein C, protein S activities, and PAI-1 values, but changes were mostly within reference range.
authors.affiliation: 1Department of Transfusion Medicine, Cakovec County Hospital, Cakovec, Croatia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Oslakovic
authors.forename: Renata
authors.initials: R
authors.lastname: Zadro
mesh_terms: D000293:Adolescent; D000328:Adult; D000990:Antithrombin III / Q000378:metabolism; D001779:Blood Coagulation Factors / Q000008:administration & dosage*; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D011372:Progestins / Q000008:administration & dosage*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D001779:Blood Coagulation Factors; D003276:Contraceptives, Oral; D011372:Progestins; D000990:Antithrombin III; D005340:Fibrinogen
keywords: blood coagulation factors; clinical pharmacology; gynecology and obstetrics