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The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives.
Br J Obstet Gynaecol. 1996 Mar; 103(3):261-7.BJ

Abstract

OBJECTIVE

To determine the effect of oestrogen dose and progestogen type on the coagulation and fibrinolytic systems of a group of normal healthy women taking three different oral contraceptive combinations.

DESIGN

Plasma levels of factor VII, X, antithrombin III, protein C, fibrinogen, tissue plasminogen activator activity, plasminogen activator inhibitor I antigen and fibrin (D-dimer) degradation products were measured at pretreatment, 6, 14, 22 weeks of treatment and at 6 weeks post-treatment in a group of 67 women taking either 30 micrograms ethinyloestradiol/150 micrograms desogestrel (n = 21), 20 micrograms ethinyloestradiol/150 micrograms desogestrel (n = 24), 30 micrograms ethinyloestradiol/75 micrograms gestodene (n = 22).

PARTICIPANTS

Sixty-seven healthy normal women, 18 to 34 years, smoking fewer than 15 cigarettes per day. The subjects were within 10% of their normal body weight and had no history of thromboembolic disease.

SETTING

Coombe Women's Hospital and St James's Hospital, Dublin, Ireland.

RESULTS

Factor VII and X levels were significantly raised on treatment with both the 30 micrograms ethinyloestradiol/desogestrel and gestodene combinations. Higher levels of factor VII activity were observed in the 30 micrograms ethinyloestradiol/desogestrel combination compared with the gestodene combination. Factor VII and X were not significantly affected by the 20 micrograms ethinyloestradiol combination. Increased plasminogen, fibrinogen and D-dimer levels and decreased plasminogen activator inhibitor I antigen levels were observed during the treatment phases in all three groups. Antithrombin III and protein C activity did not change during treatment with any of the oral contraceptives studied.

CONCLUSIONS

Low dose oral contraceptives cause an activation of the coagulation system which is balanced by an activation of the fibrinolytic system. Reducing the dose of ethinyloestradiol from 30 micrograms to 20 micrograms reduces the effect on factor VII and X. This effect can be modified by the progestogen. The lesser effect of the 20 micrograms combination may make this a safer option for some women than pills containing a higher dose of oestrogen.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Coombe Women's Hospital, Dublin.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8630312

Citation

Norris, L A., and J Bonnar. "The Effect of Oestrogen Dose and Progestogen Type On Haemostatic Changes in Women Taking Low Dose Oral Contraceptives." British Journal of Obstetrics and Gynaecology, vol. 103, no. 3, 1996, pp. 261-7.
Norris LA, Bonnar J. The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives. Br J Obstet Gynaecol. 1996;103(3):261-7.
Norris, L. A., & Bonnar, J. (1996). The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives. British Journal of Obstetrics and Gynaecology, 103(3), 261-7.
Norris LA, Bonnar J. The Effect of Oestrogen Dose and Progestogen Type On Haemostatic Changes in Women Taking Low Dose Oral Contraceptives. Br J Obstet Gynaecol. 1996;103(3):261-7. PubMed PMID: 8630312.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives. AU - Norris,L A, AU - Bonnar,J, PY - 1996/3/1/pubmed PY - 1996/3/1/medline PY - 1996/3/1/entrez KW - Biology KW - Blood Coagulation Effects KW - Clinical Research KW - Comparative Studies KW - Contraception KW - Contraceptive Agents, Estrogen--administraction and dosage KW - Contraceptive Agents, Female--administraction and dosage KW - Contraceptive Agents, Progestin--administraction and dosage KW - Contraceptive Agents--administraction and dosage KW - Contraceptive Methods KW - Desogestrel--administraction and dosage KW - Developed Countries KW - Ethinyl Estradiol--administraction and dosage KW - Europe KW - Family Planning KW - Fibrinolysis KW - Gestodene--administraction and dosage KW - Health KW - Hematological Effects KW - Hemic System KW - Ireland KW - Northern Europe KW - Oral Contraceptives KW - Oral Contraceptives, Low-dose KW - Physiology KW - Public Health KW - Research Methodology KW - Research Report KW - Safety KW - Studies SP - 261 EP - 7 JF - British journal of obstetrics and gynaecology JO - Br J Obstet Gynaecol VL - 103 IS - 3 N2 - OBJECTIVE: To determine the effect of oestrogen dose and progestogen type on the coagulation and fibrinolytic systems of a group of normal healthy women taking three different oral contraceptive combinations. DESIGN: Plasma levels of factor VII, X, antithrombin III, protein C, fibrinogen, tissue plasminogen activator activity, plasminogen activator inhibitor I antigen and fibrin (D-dimer) degradation products were measured at pretreatment, 6, 14, 22 weeks of treatment and at 6 weeks post-treatment in a group of 67 women taking either 30 micrograms ethinyloestradiol/150 micrograms desogestrel (n = 21), 20 micrograms ethinyloestradiol/150 micrograms desogestrel (n = 24), 30 micrograms ethinyloestradiol/75 micrograms gestodene (n = 22). PARTICIPANTS: Sixty-seven healthy normal women, 18 to 34 years, smoking fewer than 15 cigarettes per day. The subjects were within 10% of their normal body weight and had no history of thromboembolic disease. SETTING: Coombe Women's Hospital and St James's Hospital, Dublin, Ireland. RESULTS: Factor VII and X levels were significantly raised on treatment with both the 30 micrograms ethinyloestradiol/desogestrel and gestodene combinations. Higher levels of factor VII activity were observed in the 30 micrograms ethinyloestradiol/desogestrel combination compared with the gestodene combination. Factor VII and X were not significantly affected by the 20 micrograms ethinyloestradiol combination. Increased plasminogen, fibrinogen and D-dimer levels and decreased plasminogen activator inhibitor I antigen levels were observed during the treatment phases in all three groups. Antithrombin III and protein C activity did not change during treatment with any of the oral contraceptives studied. CONCLUSIONS: Low dose oral contraceptives cause an activation of the coagulation system which is balanced by an activation of the fibrinolytic system. Reducing the dose of ethinyloestradiol from 30 micrograms to 20 micrograms reduces the effect on factor VII and X. This effect can be modified by the progestogen. The lesser effect of the 20 micrograms combination may make this a safer option for some women than pills containing a higher dose of oestrogen. SN - 0306-5456 UR - https://www.unboundmedicine.com/medline/citation/8630312/The_effect_of_oestrogen_dose_and_progestogen_type_on_haemostatic_changes_in_women_taking_low_dose_oral_contraceptives_ L2 - https://www.lens.org/lens/search/patent/list?q=citation_id:8630312 DB - PRIME DP - Unbound Medicine ER -