Oral and Intravenous Estrogens in the Treatment and Prevention of Bleeding Associated With Long‐term Anticoagulant Therapy

Treatment of Diabetic Retinopathy With Estrogens

“…The author has acquired an extensive experience with the use of this preparation in the management of bleeding episodes in patients being maintained with long‐term anticoagulant therapy (18), in severe gastro‐intestinal hemorrhage, in cirrhosis of the liver, in severe prostatism, and in patients seriously ill with congestive heart failure, myocardial infarction or stroke (19). When given as directed, no serious side‐effects have been noted.…”

“…Estrogens have proved of value as hemostatic agents—particularly when administered intravenously—for the control of epistaxis in hemorrhagic telangiectasia, hemoptysis in pulmonary tuberculosis, delayed post‐traumatic hemorrhage, corticosteroid‐induced ecchymoses, anticoagulant‐induced bleeding, functional uterine bleeding, massive gastro‐intestinal hemorrhage associated with cirrhosis, and the bleeding following tonsillectomy, prostatectomy or ophthalmic surgery. (18, 19, 50–57) As far back as 1933, it was shown that abnormal bleeding times in newborn infants could be lowered by administration of crystallized estrin (Theelin) parenterally (58). The case is on record of an elderly hemophiliac in whom massive hemorrhage following dental extraction had been uncontrollable until the administration of estrogens (Premarin) intravenously (59).…”

Long‐term Weight Reduction in Cardiovascular Disease: Experiences With a Hypocaloric Food Mixture (Metrecal) in 78 Patients

“…Several of the female patients were concomitantly receiving small amounts of an estrogenic preparation (usually 0.3 mg. of Premarin daily), but such a dosage was considered insufficient to induce cholesterol changes of the magnitude observed. [Estrogenic therapy in female patients with coronary heart disease undergoing long‐term treatment with anticoagulants not only may enhance their comfort and improve their prognosis, but may prevent or minimize bleeding (37, 38). ]…”

Estrogenic Control of Corticosteroid‐induced Bruising, With a Commentary on Estrogen‐corticosteroid Interrelationships

“…However, the writer's observations on the control of corticosteroid‐induced cutaneous bleeding by administration of relatively small amounts of estrogenic substances are the result of several long‐term studies on the value of estrogens for the management of bleeding in other pressing medical disturbances for which specific therapy currently is lacking. Such situations have included bleeding as a complication of long‐term anticoagulant therapy (4), retinal bleeding associated with diabetic retinopathy (17), massive upper gastrointestinal hemorrhage (both variceal and nonvariceal) (16, 18), and bleeding due to hemorrhagic telangiectasia (19). Reports by others also have appeared regarding the control of bleeding by oral and intravenous administration of estrogens in hemorrhagic telangiectasia (20, 21), delayed post‐traumatic hemorrhage, functional uterine bleeding, traumatic hyphema (22), and bleeding (including fibrinolysis) following tonsillectomy, prostatectomy and ophthalmic surgery (23–28).…”

“…In the course of observing the control of bleeding manifestations by oral and intravenous administration of estrogen in patients receiving long‐term anticoagulant therapy, the writer encountered several patients whose bleeding occurred mainly in the form of purpuric and ecchymotic lesions (4). The institution of estrogen by mouth concomitantly with the anticoagulant proved to be highly effective in reducing this bleeding.…”