Hormonal contraception in terms of effect on the hemostasis system
DOI: 10.32364/2618-8430-2023-6-2-130-137
E.G. Kudinova
Novosibirsk State University, Novosibirsk, Russian Federation
Aim: to study the hemostasis indicators in female patients with hyperandrogenism (HA) and menstrual disorders (MDs) during combined oral contraceptive (COC) intake, depending on the presence of undifferentiated connective tissue displasia (UCTD).
Patients and Methods: the study results of 28 female patients with HA and MDs were divided into 2 groups: group 1 — 22 patients (mean age 22.1±3.2 years) with UCTD, group 2 — 6 patients (mean age 20.5±1.8 years) without UCTD. The content of hormones in the blood (on the 2nd–3rd day of the menstrual period), the parameters of hemostasis before and after 1 month of COCs intake, and the level of homocysteine were determined in all patients.
Results: the analysis revealed an increase in the levels of platelet activation markers, coagulation link and fibrinolysis. During COCs intake, an increase in the fibrinogen content was noted in patients of both groups, which, however, did not exceed the reference values. During the correlation analysis, it was found that in groups 1 and 2, the parameters of the fibrinogen baseline, D-dimer and the corresponding indicators after 1 month of COCs intake had a strong correlation with each other (r=0.845, r=0.864). However, group 1 had higher levels of fibrinogen and fibrin degradation products (D-dimer) (p<0.0001) versus those in group 2. The study on the trend of prothrombin time (PTT) and activated partial thromboplastin time (APTT) during COCs intake in female patients with HA and UCTD revealed an acceleration of indicators (p<0.01) versus those before COCs intake. At the same time, the change in blood clotting markers was not realized by episodes of thrombosis in any of the patients.
Conclusion: patients with UCTD had changes that characterized the activation of thrombogenesis. When planning hormonal contraception, it is necessary to single out a group of female patients with HA and signs of UCTD as the most vulnerable in relation to an increased risk of thrombogenic events.
Keywords: hyperandrogenism, combined oral contraceptive, thrombosis, connective tissue dysplasia, hyperhomocysteinemia.
For citation: Kudinova E.G. Hormonal contraception in terms of effect on the hemostasis system. Russian Journal of Woman and Child Health. 2023;6(2):–137 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-130-137.
About the author:
Evgeniya G. Kudinova — Dr. Sc. (Med.), associate professor of the Department of Obstetrics and Gynecology, V. Zelman Institute of Medicine and Psychology, Novosibirsk State University; 1, Pirogov str., Novosibirsk, 630090, Russian Federation; ORCID iD 0000-0002-1987-0343. Contact information: Evgeniya G. Kudinova, e-mail: e.kudinova@g.nsu.ru.
Financial Disclosure: the author has no a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 09.01.2023.
Revised 01.02.2023.
Accepted 28.02.2023.
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