Effects of combined oral contraceptives on hemostasis in women of late reproductive age

Аннотация

Objective: To investigate the effects of combined oral contraceptives (COCs) on hemostasis in women of late reproductive and perimenopausal age.

Полный текст

Methods: 64 women within the age interval of 35-49 years were accepted to the study. Three different formulations of COCs were used: 20 g ethinylestradiol with 150 g desogestrel, 30 g ethinylestrad with 150 g desogestrel and 30 g ethinylestradiol with 300 g norgestrel. 13 different parameters of hemostasis including resistance to activated protein C (APC resistance) and presence of Lupus anticoagulant were evaluated at the commencement of the study and after 2 and 6 cycles of COCs intake. The presence of Lupus anticoagulant was detected using tissue thromboplastin inhibition test. Test for identification of the factor V Leiden mutation based on polymerize chain reaction (PCR) was performed as well.

Results: There was a significant reduction of APC-ratio in heterozygous carriers of factor V Leiden as compared to women without this mutation (2,1±0,1 and 2,7±0,1; p<0,01). The presence of lupus anticoagulant was identified more frequently in women with the factor V Leiden mutation using COCs (p,0,01). There was a significant reduction of APC-ratio in these women as well (1,7±0,1 and 2,1±0,1; p<0,01). APC resistance was diagnosed in 3,1% of the participants without the factor V Leiden mutation before the treatment and in 14,1% - after COCs use (p<0,05). The prevalence of APC-resistance was higher in COC users with Lupus anticoagulant as compared to those without this anticoagulant (25,0% - 8,7%, p<0,05).

Conclusions: Apparently APS-resistance and Lupus anticoagulant may be involved in the development of thrombophilia associated with COC use.