Effects of Oral and Transdermal Hormonal Contraception on Vascular Risk Markers

Department of Obstetrics and Gynecology, University of Vermont, Burlington, Vermont 0450, USA.
Obstetrics and Gynecology (Impact Factor: 5.18). 03/2008; 111(2 Pt 1):278-84. DOI: 10.1097/AOG.0b013e3181626d1b
Source: PubMed


To compare the effects of oral and transdermal contraceptives containing similar hormone formulations on vascular risk markers.
We conducted a randomized, investigator-blinded, crossover, clinical trial with 24 healthy women, aged 18-35 years, who received 2 months of transdermal or oral contraceptive, 2 months washout, then 2 months of the alternative medication. The transdermal contraceptive contained 0.75 mg ethinyl estradiol and 6 mg norelgestromin. The oral contraceptive contained 35 mcg ethinyl estradiol and 250 mcg norgestimate. Blood samples taken before and after each treatment were analyzed in batch for D-dimer, von Willebrand factor, factor VIII, total and free protein S, antithrombin, fibrinogen, C-reactive protein, and normalized activated protein C sensitivity ratio (nAPCsr) determined with two thrombin generation-based assays, the alpha2macroglobulin-thrombin end point method (alpha2M-IIa) and calibrated automated thrombinography. Repeated measures analysis of variance was used for analysis.
For both contraceptives (transdermal, oral) there were significant declines in free (19%, 11%) and total protein S (19%, 13%) and antithrombin (13%, 10%); increases in fibrinogen (8%, 10%), C-reactive protein (220%, 292%), nAPCsr alpha2M-IIa (81%, 61%), and nAPCsr calibrated automated thrombinography (102%, 68%), all P<.05. Transdermal contraceptives had a greater effect than oral contraceptives on free protein S (P=.07), nAPCsr alpha2M-IIa (P=.06), and nAPCsr calibrated automated thrombinography (P=.03).
Oral and transdermal contraception with similar hormones had similar adverse effects on vascular risk markers. This suggests that this transdermal contraceptive has at least a similar thrombosis risk as its oral counterpart.,, NCT00554632

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    • "Podczas przyjmowania antykoncepcji doustnej prawidłowy poziom niemal wszystkich białek układu krzepnięcia zostaje zaburzony. Nawet nieduże odstępstwo od normy jednego białka układu krzepnięcia zaburza delikatną równowagę i może powodować uruchomienie całej kaskady układu krzepnięcia i fibrynolizy [6] [7] [8] [9] [10]. Janczewski i wsp. "
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    Otolaryngologia polska. The Polish otolaryngology 02/2013; 67(1):25–29. DOI:10.1016/j.otpol.2012.09.008
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    ABSTRACT: The use of oral contraceptives (OC) is a well established risk factor for venous thrombosis. It has been known for many years that almost all haemostatic parameters i.e. plasma levels of coagulation factors, anticoagulant proteins and proteins involved in the fibrinolytic pathway change during OC use. The discovery of several risk factors of venous thrombosis in the 1990s shed new light on the association between the effects of OC on the haemostatic system and the increased risk of venous thrombosis. In this review, we summarize the current knowledge on the effects of different kinds of hormonal contraceptives (OC, transdermal contraceptives, vaginal ring and levonorgestrel-releasing intrauterine device) on haemostatic variables and the relationship between the changes of these variables and the risk of venous thrombosis.
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    BMC Medical Genetics 02/2008; 9(1):77. DOI:10.1186/1471-2350-9-77 · 2.08 Impact Factor
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