Coagulation Activation Following Estrogen Administration to Postmenopausal Women

Yehezkel G Caine; Kenneth A Bauer; Samad Barzegar; Hugo ten Cate; Frank M Sacks; Brian W Walsh; Isaac Schiff; Robert D Rosenberg

doi:10.1055/s-0038-1646283

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1992; 68(04): 392-395
DOI: 10.1055/s-0038-1646283

Original Article

Schattauer GmbH Stuttgart

Coagulation Activation Following Estrogen Administration to Postmenopausal Women

Yehezkel G Caine

The Department of Medicine, Beth Israel Hospital and Brockton-West Roxbury Department of Veterans Affairs Medical Center; Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston; and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA

,

Kenneth A Bauer

The Department of Medicine, Beth Israel Hospital and Brockton-West Roxbury Department of Veterans Affairs Medical Center; Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston; and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA

,

Samad Barzegar

The Department of Medicine, Beth Israel Hospital and Brockton-West Roxbury Department of Veterans Affairs Medical Center; Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston; and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA

,

Hugo ten Cate

The Department of Medicine, Beth Israel Hospital and Brockton-West Roxbury Department of Veterans Affairs Medical Center; Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston; and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA

,

Frank M Sacks

The Department of Medicine, Beth Israel Hospital and Brockton-West Roxbury Department of Veterans Affairs Medical Center; Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston; and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA

,

Brian W Walsh

The Department of Medicine, Beth Israel Hospital and Brockton-West Roxbury Department of Veterans Affairs Medical Center; Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston; and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA

,

Isaac Schiff

The Department of Medicine, Beth Israel Hospital and Brockton-West Roxbury Department of Veterans Affairs Medical Center; Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston; and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA

,

Robert D Rosenberg

The Department of Medicine, Beth Israel Hospital and Brockton-West Roxbury Department of Veterans Affairs Medical Center; Channing Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston; and the Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA

› Author Affiliations

Abstract

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Summary

We investigated coagulation system activation following estrogen treatment in 29 healthy postmenopausal women. Study participants received conjugated estrogens at 0.625 and 1.25 mg per day, and placebo for 3-month periods in a randomized crossover protocol. Blood samples were obtained on two consecutive days at the end of each treatment period for immunoassays of F₁+2 and fibrinopeptide A (FPA), markers of factor Xa action on prothrombin and thrombin action on fibrinogen in vivo, respectively. Treatment with estrogens at a dose of 0.625 or 1.25 mg resulted in significant increases in mean F₁₊₂ levels of 40 and 98%, respectively, and in mean FPA levels of 37 and 71%, respectively. The measurements of F₁₊₂ were significantly higher in women receiving 1.25 mg of estrogen than 0.625 mg. We also observed significant declines in the levels of antithrombin III and total protein S antigen. Immunologic levels of protein C increased modestly at only the 1.25 mg estrogen dose level. These data indicate that low doses of oral estrogens (≤1.25 mg per day) frequently increase the amount of thrombin generated in vivo. Our observations may help to explain the increased thrombotic risk that has been observed with higher doses of this medication (≥2.5 mg).

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References

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