Platelet Adhesiveness in Symptomatic Women Taking Oral Contraceptives

1971 ◽  
Vol 26 (03) ◽  
pp. 426-430 ◽  
Author(s):  
T. F Zuck ◽  
J. J Bergin ◽  
Jane M. Raymond ◽  
W. R Dwyre ◽  
D. G Corby
Keyword(s):  
Oral Contraceptives ◽  
Platelet Adhesiveness ◽  
Combined Oral Contraceptives ◽  
Increased Risk ◽  
Normal Women ◽  
Asymptomatic Women

SummaryPlatelet adhesiveness to glass was determined in several groups of women. Increases were found in women developing thrombovascular symptoms while taking combined oral contraceptives, compared to both normal women and asymptomatic users of oral contraceptives. Despite this increase, overlap of the groups did not permit discrimination between symptomatic and asymptomatic women. However, it is possible, that in concert with other coagulation changes, platelet adhesiveness to glass may prove adjunctive in defining women at increased risk of developing thrombovascular symptoms while taking oral contraceptives, and further define the mechanism of the increased risk.

scholarly journals Combined Oral Contraceptives and Venous Thromboembolism: Review and Perspective to Mitigate the Risk

2021 ◽  
Vol 12 ◽  
Author(s):  
Laure Morimont ◽  
Hélène Haguet ◽  
Jean-Michel Dogné ◽  
Ulysse Gaspard ◽  
Jonathan Douxfils
Keyword(s):  
Venous Thromboembolism ◽  
Oral Contraceptives ◽  
Health Care Professionals ◽  
Contraceptive Method ◽  
Natural Form ◽  
Thrombotic Risk ◽  
Combined Oral Contraceptives ◽  
Hereditary Thrombophilia ◽  
Increased Risk ◽  
The Impact

Many factors must be considered and discussed with women when initiating a contraceptive method and the risk of venous thromboembolism (VTE) is one of them. In this review, we discuss the numerous strategies that have been implemented to reduce the thrombotic risk associated with combined oral contraceptives (COCs) from their arrival on the market until today. Evidences suggesting that COCs were associated with an increased risk of VTE appeared rapidly after their marketing. Identified as the main contributor of this risk, the dosage of the estrogen, i.e., ethinylestradiol (EE), was significantly reduced. New progestins were also synthetized (e.g., desogestrel or gestodene) but their weak androgenic activity did not permit to counterbalance the effect of EE as did the initial progestins such as levonorgestrel. Numerous studies assessed the impact of estroprogestative combinations on hemostasis and demonstrated that women under COC suffered from resistance towards activated protein C (APC). Subsequently, the European Medicines Agency updated its guidelines on clinical investigation of steroid contraceptives in which they recommended to assess this biological marker. In 2009, estradiol-containing COCs were marketed and the use of this natural form of estrogen was found to exert a weaker effect on the synthesis of hepatic proteins compared to EE. In this year 2021, a novel COC based on a native estrogen, i.e., estetrol, will be introduced on the market. Associated with drospirenone, this preparation demonstrated minor effects on coagulation proteins as compared with other drospirenone-containing COCs. At the present time, the standard of care when starting a contraception, consists of identifying the presence of hereditary thrombophilia solely on the basis of familial history of VTE. This strategy has however been reported as poorly predictive of hereditary thrombophilia. One rationale and affordable perspective which has already been considered in the past could be the implementation of a baseline screening of the prothrombotic state to provide health care professionals with objective data to support the prescription of the more appropriate contraceptive method. While this strategy was judged too expensive due to limited laboratory solutions, the endogenous thrombin potential-based APC resistance assay could now represent an interesting alternative.

scholarly journals Venous thromboembolism and oral contraception

2010 ◽  
Vol 63 (5-6) ◽  
pp. 376-379 ◽  
Author(s):  
Milena Veljkovic ◽  
Jasmina Popovic
Keyword(s):  
Venous Thromboembolism ◽  
Oral Contraceptives ◽  
Absolute Risk ◽  
Oral Contraception ◽  
Dependent Manner ◽  
Substantial Impact ◽  
Combined Oral Contraceptives ◽  
Increased Risk ◽  
The Absolute ◽  
Dose Dependent

Introduction. Because of their safety and efficacy, oral contraceptives are available without prescription in many countries. Monophasic combined oral contraceptives are a combination of estrogen and progestin taken in constant amounts. Venous thromboembolism. Combined oral contraceptives slightly increase the risk of venous thromboemolism, but this event is very rare among non-pregnant women of reproductive age. The absolute risk rises with age, obesity, recent surgery and certain forms of thrombophilia. The estrogen component of combined oral contraceptives increases the synthesis of several coagulation factors in a dose-dependent manner. Changes of most of these parameters are very small and there is no evidence that they have any effect upon the clinical risk of developing venous thrombosis. If a woman has an inherited coagulation disorder that increases her risk of developing thrombosis, the risk is increased several fold if she ingests estrogen containing oral contraception. Conclusion. The increased risk of venous thromboembolism associated with combined oral contraceptives should have little impact on healthy women, but may have substantial impact on women with a history of thromboembolism. Combined oral contraceptive use increases the risk of venous thromboembolosm in a dose-dependent manner. The absolute risk of venous thromboembolism rises with age, obesity, recent surgery and certain forms of thrombophilia, as well.

scholarly journals Risks of venous thromboembolic complications in related to combined oral contraceptives

2022 ◽  
Vol 15 (6) ◽  
pp. 777-787
Author(s):  
K. A. Gabelova ◽  
N. A. Shabanova ◽  
V. F. Bezhenar ◽  
E. E. Zvartau ◽  
Yu. A. Akishina
Keyword(s):  
Oral Contraceptives ◽  
Unwanted Pregnancy ◽  
Hormonal Contraception ◽  
Vena Cava ◽  
Thromboembolic Complications ◽  
Combined Oral Contraceptives ◽  
Increased Risk ◽  
Venous Thromboembolic ◽  
Reversible Method ◽  
Thrombotic Complications

Hormonal contraception is the most popular and effective reversible method for preventing unwanted pregnancy exerting multiple prophylactic and therapeutic effect along with contraceptive activity. The main adverse coupled to combined oral contraceptives (COCs) is its impact on the hemostasis and increased risk of venous thromboembolic complications. A great evolutionary path has been travelled after beginning application of hormonal contraception to reduce dose of its estrogen component and improving quality of gestagen component. Nevertheless, thrombotic complications related to COCs use still remain a pressing issue not only due to disease severity and high mortality rate from pulmonary embolism (PE), but also due to the difficulties in its timely diagnostics. Here we describe a clinical case of a 19-year-old patient suffering from vena cava inferior thrombosis complicated by PE after using COCs.

Contraception modes: increasing women’s commitment to modern combined oral contraceptives with the shortest possible hormone-free interval

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 46-50
Author(s):  
Elena N. Andreeva ◽  
Ekaterina V. Sheremetyeva
Keyword(s):  
Oral Contraceptives ◽  
Clinical Manifestations ◽  
Well Being ◽  
Reproductive Age ◽  
World Health ◽  
Cochrane Library ◽  
Childbearing Age ◽  
Combined Oral Contraceptives ◽  
Free Interval ◽  
Increased Risk

By definition, contraception is the prevention of pregnancy and infection from diseases by mechanical, chemical and other contraceptives and methods. According to World Health Organization (WHO) statistics, up to 40% of women of reproductive age still believe that their needs for family planning services are not met during counseling. When recommending contraception, it is important to consider: the characteristics of the potential consumer, the underlying risk of the disease, possible undesirable drug reactions of various drugs, the cost, availability and preferences of the woman herself. Women are often forced to abandon the use of a contraceptive method in connection with adverse events, for example, when using combined oral contraceptives (COCs), they may feel worse (headaches, mood lability, weight gain, swelling, decreased libido) in a hormone-free interval, especially with the reception mode 21/7. Lack of contraception can lead to an increased risk of an unwanted pregnancy. According to statistics in the Russian Federation in 2018, the absolute number of abortions amounted to 567 183, which, according to the UN classification, corresponds to the average level (level of abortion rate per 1000 women of childbearing age). According to clinical practice, there is a relationship between deterioration of well-being and the duration of the hormone-free interval. At the moment, in our country there is the only COC, which has a hormone-free interval of 2 days, containing bioidentical estrogen estradiol valerate and dienogest. According to the Cochrane Library, COCs with a short hormone-free interval are most effective in relation to the clinical manifestations of the estrogen withdrawal syndrome. WHO calls on clinicians to raise womens awareness of modern methods of contraception.

Increased Heparin Cofactor II Levels in Women Taking Oral Contraceptives

1990 ◽  
Vol 64 (03) ◽  
pp. 365-368 ◽  
Author(s):  
P Toulon ◽  
J M Bardin ◽  
N M Blumenfeld
Keyword(s):  
Oral Contraceptives ◽  
Antithrombin Iii ◽  
Thrombin Inhibitor ◽  
Control Groups ◽  
Normal Range ◽  
Heparin Cofactor Ii ◽  
Men And Women ◽  
Pooled Data ◽  
Contraceptive Pills ◽  
Increased Risk

SummaryHeparin cofactor II (HCII) is a thrombin inhibitor present in human plasma whose activity is enhanced by heparin. HCII exhibits important homologies with antithrombin III, the main heparin-enhanced thrombin inhibitor. Cases of recurrent thromboembolism have been recently reported in patients with HCII deficiency. Since the use of oral contraceptives (OC) is associated with an increased risk of thrombosis, the study of the plasma levels of HCII was undertaken in women taking contraceptive pills. Plasma HCII levels were found significantly higher in 62 women taking low-estrogen content OC (1.20 ± 0.28 U/ml) than in 62 age matched women not taking OC (0.94 ± 0.16 U/ml) or in 62 men (0.96 ± 0.19 U/ml). Significant correlations between HCII and fibrinogen levels were reported in the three groups. From the pooled data of the two control groups (men and women not taking OC), the normal range for plasma HCII levels was defined to be between 0.60 and 1.30 U/ml (mean ± 2 SD). Two cases of low HCII levels (<0.60 U/ml) were found in the control groups, but none in the group of women taking OC. It is concluded that the use of oral contraceptives is associated with a rise in HCII levels and that the screening for HCII deficiency has to be performed at distance of any OC therapy.

Decreased Levels of Histidine-Rich Glycoprotein (HRG) and Increased Levels of Free Plasminogen in Women on Oral Contraceptives Low in Estrogen

1982 ◽  
Vol 48 (03) ◽  
pp. 283-285 ◽  
Author(s):  
Jørgen Jespersen ◽  
Cornelis Kluft
Keyword(s):  
Oral Contraceptives ◽  
Ethinyl Estradiol ◽  
Relative Increase ◽  
Normal Group ◽  
Plasma Samples ◽  
Normal Women ◽  
Made In

SummaryDeterminations by immunologic methods of histidine-rich glycoprotein (HRG) and plasminogen, were made in plasma samples collected during one normal or hormone induced cycle in 15 young, normal women and in 11 women using oral contraceptives with 30 μg ethinyl estradiol and 150 μg levo-norgestrel. The hormone group showed an increase in plasminogen level to about 150% of normal, while the concentration of HRG was decreased to about 75% of normal. This resulted in a considerable relative increase in the concentration of free plasminogen in the hormone group (calculated from the equilibrium: HRG·plasminogen ⇌ HRG + plasminogen, using KD = 1.0 μM), representing a doubling of that in the normal group. Hence, more plasminogen is available for binding to fibrin and activation in the hormone group.

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