Thrombosis and sex hormones: a perplexing liaison
Wessler, S.
Journal of Laboratory and Clinical Medicine 96(5): 757-761
1980
ISSN/ISBN: 0022-2143 PMID: 6999103 Document Number: 164933
The association between thrombosis and use of oral contraceptives has been confirmed again and again by epidemiologic data. However, what remains to be accomplished is the means of identifying at risk individuals and discovering how steroids interfere in hemostatic mechanisms. One method of determining at risk patients would be to define a hypercoagulable state attributable to contraceptives. No clear evidence exists that oral contraceptives are inducers of thrombotic states, but that they may be facilitators is suggested by results of 2 different studies. Women with preexisting fibrinolysis impairment were found to experience thrombosis, and a change in coagulation inhibitor reaction rates was associated with use of contraceptives. A new study by Gordon et al. adds to the mounting evidence of a link between thrombosis and contraceptive use. Functionally and immunologically a marked elevation in Hageman factor and an increase in C1 inhibitor were found in oral contraceptive users between Days 14 and 20 of their cycles, suggesting that the increase in Hageman factor may enhance in vitro fibrinolysis possibly abetted by diminished control by C1 inhibitor.