Download PDF
Thromb Haemost 1997; 77(01): 105-108
DOI: 10.1055/s-0038-1655915
Coagulation
Schattauer GmbH Stuttgart

The Effect of Progesterone on the Haemostatic Mechanism

M Blombäck
1   The Department of Laboratory Medicine/Blood Coagulation Research, University of Stockholm, Sweden
,
B-M Landgren
2   The Department of Woman and Child Health, Division for Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden
,
Y Stiernholm
2   The Department of Woman and Child Health, Division for Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden
,
O Andersson
3   The Department of Psychology, University of Stockholm, Sweden
› Author Affiliations
Further Information

Publication History

Received 24 April 1996

Accepted after resubmisssion 16 September 1996

Publication Date:
11 July 2018 (online)

Also available at
  PDF Download  Permissions and Reprints

Summary

The hemostatic effect of progesterone administered vaginally at a dose of 100 mg twice a day throughout one menstrual cycle was investigated and compared with the coagulation factors in one untreated normal menstrual cycle in 15 women. The progesterone treatment resulted in a 20-fold progesterone rise in the early follicular phase from 1.2 nmol/1 in the pretreatment control cycle to levels between 26 and 29 nmol/1 during treatment. Ovulation was completely suppressed in seven women while eight women showed a slight rise in progesterone on treatment days 20 to 25 not compatible with the rise which could have been expected if ovulation had occurred. The effects found on haemostasis during progesterone treatment varied with the menstrual cycle and were so small that they could as well be due to chance and not to treatment.

 

  • References

  • 1 Bonnar J. Coagulation effects of oral contraception. Am J Obstet Gynecol 1987; 157: 1042-1048
    CrossrefPubMedGoogle Scholar
  • 2 Robinson GE. Low dose combined oral contraceptives. Br J Obstet Gynaecol 1994; 101: 1036-1041
    CrossrefPubMedGoogle Scholar
  • 3 Jespersen J, Petersen KR, Skouby SO. Effects of newer contraceptives on the inhibition of coagulation and fibrinolysis in relation to dosage and type of steroid. Am J Obstet Gynecol 1990; 163: 396-403
    CrossrefPubMedGoogle Scholar
  • 4 Kooistra T, Bosma JP, Jespersen J, Kluft C. Studies on the mechanism of action of oral contraceptives with regard to fibrinolytic variables. Am J Obstet Gynecol 1990; 163: 404-413
    CrossrefPubMedGoogle Scholar
  • 5 Fotherby K. The progestogen-only pill and thrombosis. Br J Fam Plann 1989; 15: 83-85
    PubMedGoogle Scholar
  • 6 Jick H, Jick SS, Gurewich V, Myers W, Vasilakis C. Risk of idiopathic cardiovascular death and nonfatal venous thromboembolism in women using oral contraceptives with progestagen components. Lancet 1995; 346: 1589-1592
    CrossrefPubMedGoogle Scholar
  • 7 World Health Organization, Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Effect of different progestagens in low estrogen oral contraceptives on venous thrombotic disease. Lancet 1995; 346: 1582-1588
    CrossrefPubMedGoogle Scholar
  • 8 World Health Organization, Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Venous thromboembolic disease and combined oral contraceptives: results of international multicentre case-control study. Lancet 1995; 346: 1575-1581
    CrossrefPubMedGoogle Scholar
  • 9 Bloemenkamp KWM, Roosendaal FR, Helmerhaust FM, Büller HR, Vandenbroucke JP. Enhancement by factor V Leiden mutation of risk of deep-vein thrombosis associated with oral contraceptives containing a third generation progestagen. Lancet 1995; 346: 1593-1596
    CrossrefPubMedGoogle Scholar
  • 10 Weiss N. Third-generation oral contraceptives: how risky?. Lancet 1994; 346: 1570
    PubMedGoogle Scholar
  • 11 Aune B, Höie KE, Öian P, Holst N, Østerud B. Does ovarian stimulation for in-vitro fertilization induce a hypercoagulable state?. Hum Reprod 1991; 07: 925-927
    PubMedGoogle Scholar
  • 12 Bremme K, Wramsby H, Andersson O, Wallin M, Blombäck M. Do lowered factor VII levels at extremely high endogenous oestradiol levels protect against thrombin formation?. Blood Coag Fibrinolysis 1994; 05: 205-210
    CrossrefPubMedGoogle Scholar
  • 13 Sitruk-Ware R, Bricarie C, de LignersB, Yaneva H, Mauvais-Jarvis P. Oral micronized progesterone. Contraception 1987; 36: 373-402
    CrossrefPubMedGoogle Scholar
  • 14 Landgren B-M, Unden A-L, Diczfalusy E. Hormonal profile of the cycle in 68 normally menstruating women. Acta Endocrinol 1980; 94: 89-98
    PubMedGoogle Scholar
  • 15 Oswaldsson U, Wilson S, Rosén S. A simple chromogenic assay for the determination of Factor VII in microtiter plates. Thromb Haemost. 1977; 54: 26 (abstr. 153)
    PubMedGoogle Scholar
  • 16 Rosén S, Andersson M, Blombäck M, Hägglund U, Larrieu MJ, Wolf M, Boyer C, Rothschild C, Nilsson IM, Sjörin E, Vinazzer H. Clinical application of a chromogenic substrate method for determination of Factor VIII activity. Thromb Haemost 1985; 54: 818-823
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Abildgaard U, Lie M, Ödegaard OR. Antithrombin heparin co-factor assay with new chromogenic substrates S-2238 and Chromozym TH. Thromb Res 1977; 01: 549-553
    PubMedGoogle Scholar
  • 18 Ödegaard OR, Try K, Andersson TR. Protein C: An automated activity assay. Haemostasis 1987; 17: 109-113
    PubMedGoogle Scholar
  • 19 Chmielewska J, Wiman B. Determination of tissue plasminogen activator and its “fast” inhibitor in plasma. Clin Chem 1986; 32: 482-485
    PubMedGoogle Scholar
  • 20 Vermylen C, de VrekerRA, Verstraete M. A rapid enzymatic method for assay of fibrinogen fibrin polymerization time (FPT) test. Clin Chim Acta 1963; 08: 418-424
    CrossrefPubMedGoogle Scholar
  • 21 Silveira AMV, Yamamoto T, Adamson L, Hessel B, Blombäck B. Application of an enzyme-linked immunosorbent assay (ELISA) to von Willebrand factor (vWF) and its derivatives. Thromb Res 1986; 43: 91-102
    CrossrefPubMedGoogle Scholar
  • 22 Pelzer H, Schwarz A, Heimburger N. Determination of human thrombinantithrombin III complex in plasma with enzyme-linked immunosorbent assay. Thromb Haemost 1988; 59: 101-106
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Hahn L, Cederblad G, Rybo G, Pehrsson N-G, Korsan-Bengtsen K. Blood coagulation, fibrinolysis and plasma proteins in women with normal and with excessive menstrual blood loss. Br J Obstet Gynaecol 1976; 83: 974-980
    CrossrefPubMedGoogle Scholar
  • 24 Jesperson J, Kluft C. Inhibition of tissue-type plasminogen activator in plasma of women using oral contraceptives and in normal women during a menstrual cycle. Thromb Haemost 1986; 55: 388-389
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Lebech A-M, Kjaer A, Lebech PE. Metabolic changes during the normal menstrual cycle: A longitudinal study. Am J Obstet Gynecl 1990; 163: 414-416
    PubMedGoogle Scholar
  • 26 Cederblad G, Hahn L, Korsan-Bengtsen K, Pehrsson NG, Rybo G. Variations in blood coagulation, fibrinolysis, platelet function and various plasma proteins during the menstrual cycle. Haemostasis 1977; 06: 294-302
    PubMedGoogle Scholar
  • 27 Jespersen J. Sequential study of plasma euglobin fibrinolytic activity during the normal menstrual cycle and in women on oral contraceptives low in estrogen. Gynecol Obstet Invest 1983; 15: 266-274
    CrossrefPubMedGoogle Scholar
  • 28 Siegbahn A, Odlind V, Hedner U, Venge P. Coagulation and fibrinolysis during the normal menstrual cycle. Upsala J Med Sci 1989; 94: 137-152
    CrossrefPubMedGoogle Scholar
  • 29 Blombäck M, Eneroth P, Landgren B-M, Lagerström M, Anderson O. On the intraindividual and gender variability of haemostatic components. Thromb Haemost 1992; 67: 70-75
    Article in Thieme ConnectPubMedGoogle Scholar
  • 30 Mauvais-Jarvis P. Progesterone and progestins: A general overview. In: Progesterone and Progestins. Wayne-Bardin C, Milgrom E, Mauvais-Jarvis P. (eds). Raven Press; New York: 1983. pp 1-16
    Google Scholar
  • 31 Nahaul K, Dehennin L, Jondet I, Roger M. Profiles of plasma progesterone and their metabolites after oral or vaginal administration of estradiol or progesterone. Maturitas 1993; 16: 185-202
    CrossrefPubMedGoogle Scholar