6-oxo-Prostaglandin F_1α and Thromboxane B₂ in Uterine Vein Blood - A Possible Role in Menstrual Bleeding

Summary

The role of the haemostatic system in relation to menstrual bleeding is poorly understood. Platelet retention to glass beads and plasma concentrations of 6-oxo-PGF_α and thromboxane B₂ were measured in uterine and peripheral venous blood obtained from 18 women undergoing abdominal hysterectomy. Concentrations of 6-oxo-PGF_α were significantly (p<0.01) higher in uterine (1.4 ± 0.3 ng/ml, mean ± SEM) than in peripheral vein blood (0.2 ±0.1 ng/ml) as was the level of thromboxane B₂ (0.5 + 0.1 and 0.2 ± 0.1 ng/ml, respectively). Platelet retention in uterine vein blood (11 ± 4%) was significantly lower than in peripheral blood (42 ±4%; p<0.01) and the degree of platelet retention correlated inversely with the plasma concentration of 6-oxo-PGF_α (r −0.43; p<0.01). There was a significant rank correlation between time since menstruation and concentrations of 6-oxo-PGF_α in uterine (τ + 0.69; p<0.001) and peripheral (τ + 0.56; p<0.05) vein blood. The results indicate that an increased local production of prostacyclin (PGI₂) relative to thromboxane A₂ at the time of menstruation could contribute to the mechanism of uterine bleeding.

Keywords

Prostacyclin - Thromboxane B₂ - Uterus - Menstruation - Platelets

• References

• 1 Quick AJ. Menstruation in hereditary bleeding disorders. Obstet Gynecol 1966; 28: 37-38
• 2 Anderson ABM, Haynes PJ, Guillebaud J, Turnbull AC. Reduction of menstrual blood loss by prostaglandin synthetase inhibitors. Lancet 1976; 1: 774-776
• 3 Guillebaud J, Anderson AB, Turnbull AC. Reduction by mefanamic acid of increased menstrual blood-loss associated with intrauterine contraception. Br J Obstet Gynaecol 1978; 85: 53-62
• 4 Ylikorkala O, Kauppila A, Siljander M. Anti-prostaglandin therapy in prevention of side-effects of intrauterine contraceptive devices. Lancet 1979; 2: 393-394
• 5 Hagenfeldt K. Prostaglandins and related compounds and their metabolism in normal and steroid-exposed endometrium. Diczfalusy E, Fraser IS, Webb FTG. (eds.). Endometrial bleeding and steroidal contraception. Bath, England: Pitman Press; 1980: 222-239
• 6 Abel MH, Kelly RW. Differential production of prostaglandins within the human uterus. Prostaglandins 1979; 18: 821-828
• 7 Liggins GC, Campos GA, Roberts CM, Skinner SJ. Production rates of prostaglandin F, 6-keto-PGF_1α and thromboxane B₂ by perfused human endometrium. Prostaglandins 1980; 19: 461-467
• 8 Mustard JF, Kinlough-Rathbone RL, Packham MA. Prostaglandins and platelets. Annu Rev Med 1980; 31: 89-96
• 9 Ponari O, Civardi E, Megha S, Pini M, Portioli D, Dettori AG. Antiplatelet effects of long-term treatment with gliclazide in diabetic patients. Thromb Res 1979; 16: 191-203
• 10 Salmon JA. A radioimmunoassay for 6-keto-prostaglandin F_1α . Prostaglandins 1978; 15: 383-397
• 11 Higgs GA, Salmon JA. Cyclooxygenase products in carrageenin-induced inflammation. Prostaglandins 1979; 17: 737-746
• 12 Nossel HL. Radioimmunoassay of fibrinopeptides in relation to intravascular coagulation and thrombosis. N Engl J Med 1976; 295: 428-432
• 13 Ingerman-Wojenski C, Silver MJ, Smith JB, Macarak E. Bovine endothelial cells in culture produce thromboxane as well as prostacyclin. J Clin Invest 1981; 67: 1292-1296
• 14 Gimeno MF, Berda ES, Lazzari MA, Gimeno AL. Ovarian hormones inhibit the release of prostacyclin-like material from isolated rat uterus. Prostaglandins 1980; 20: 223-232
• 15 Hohman WR, Shaw ST, Macaulay L, Moyer DL. Vascular defects in human endothelium caused by intrauterine contraceptive devices. Contraception 1977; 16: 507-522
• 16 Aparicio SR, Bradbury K, Bird CC, Foley ME, Jenkins DM, Clayton JK, Scott JS, Rajah SM, McNicol GP. Effect of intrauterine contraceptive devices on uterine haemostasis: a morphological study. Br J Obstet Gynaecol 1979; 86: 314-324
• 17 Christiaens GCML, Sixma JJ, Haspels AA. Morphology of haemostasis in menstrual endometrium. Br J Obstet Gynaecol 1980; 87: 425-439
• 18 Smith JB, Ingelman CM, Silver MJ. Malondialdehyde formation as an indicator of prostaglandin production by human platelets. J Lab Clin Med 1976; 88: 167-172
• 19 Tindall H, Zuzel M, Paton RC, McNicol GP. Changes in thrombo-stimulated platelet malondialdehyde production during the menstrual cycle. J Clin Pathol 1981; 34: 595-598
• 20 Smith SK, Abel MH, Kelly RW, Baird DT. A role for prostacyclin (PGI₂) in excessive menstrual bleeding. Lancet 1981; 1: 522-524