The contraceptive vaginal ring (NuvaRing®) and hemostasis: a comparative study

Magnúsdóttir, Ebba Margrét; Bjarnadóttir, Ragnheiður I.; Önundarson, Páll T.; Gudmundsdottir, Brynja R.; Geirsson, Reynir Tómas; Magnúsdóttir, Sigríður; Dieben, T. O. M.

doi:10.1016/j.contraception.2003.12.010

Cited by 47 publications

(24 citation statements)

References 13 publications

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“…The ring (15 mcg of EE + 120 mcg of etonogestrel/day) was compared to COC containing 30 mcg EE + 150 mcg levonorgestrel. The result showed similar changes in hemostasis 33 . A recent study compared the effect of combined oral and vaginal contraception on hemostatic variables, and it showed a procoagulant effect due to EE, regardless of the route of administration 34 .…”

Section: Brito Et Al Hormonal Contraception and Cardiovascular Systemsupporting

confidence: 72%

Contracepção hormonal e sistema cardiovascular

Brito

Nobre²,

Vieira

2011

Arq. Bras. Cardiol.

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Hormonal contraception is the most widely used method to prevent unplanned pregnancies. The literature has shown an association between cardiovascular risk and use of hormone therapy. With the purpose of providing better guidelines on contraception methods for women with risk factors for cardiovascular disease, we have reviewed the literature on the subject. This review describes the latest data from the scientific literature concerning the influence of hormonal contraceptives on arterial thrombosis, venous thrombosis and systemic high blood pressure, which are diseases that have become increasingly prevalent among young females.

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Section: Brito Et Al Hormonal Contraception and Cardiovascular Systemsupporting

confidence: 72%

Contracepção hormonal e sistema cardiovascular

Brito

Nobre²,

Vieira

2011

Arq. Bras. Cardiol.

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“…Another published study reported no difference in TAT between NuvaRing and COC users; however, the number of participants was small. 33 We did not observe any significant correlation between age and TAT level (TAT increased 0.19 per 1 year increase in age, P ¼ .30). The same was observed for the effect of exercise hours/week (!3 hours) on TAT.…”

Section: Discussionmentioning

confidence: 87%

“…It is important to mention that all the published studies looking at surrogate blood biomarkers either lacked a sufficient sample size or studied the biomarkers within three to six 28-day cycles of use. 11,33,38,39 Our study was limited in various ways. The presented results should be interpreted cautiously and the results not considered definite as the sample size was small, and we did a relatively large number of tests.…”

Section: Discussionmentioning

confidence: 99%

“…The difference between the 2 CHC user groups was also not significant, in agreement with another published study comparing levels of PAI-1 between COC and CVC users. 33 Plasminogen activator inhibitor 1 is a glycoprotein produced by both the liver and endothelial cells. Lower levels of PAI-1 indicate higher fibrinolysis activity among CHC users.…”

Section: Discussionmentioning

confidence: 99%

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Oral Versus Vaginal Combined Hormonal Contraceptives' Effect on Coagulation and Inflammatory Biomarkers Among Young Adult Women

Divani

Luo

Brandy

et al. 2012

Clin Appl Thromb Hemost

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In order to compare the effect of combined oral contraceptive (COC) and combined vaginal contraceptive (CVC) methods on the inflammation and procoagulation, we recruited female participants in 3 groups: control participants, COC users, and CVC users. We measured different blood biomarkers. The users of both COC and CVC had higher levels of C-reactive protein (P < .0001) and factor VII (P < .0001). However, CD40 ligand was only higher for COC users (P < .0001) and not the CVC users. Even though the levels of thrombin/antithrombin III were not higher for COC and CVC users, as compared to the controls, CVC users had higher levels as compared to COC users (P ¼ .0327). As compared to the control group, we observed higher levels von Willebrand factor among CVC users but not the COC users. Longitudinal studies with larger sample size are needed to better assess the inflammatory and procoagulation response due to CVC use.

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“…7 NuvaRing 1 (Etonogestrel and Ethinylestradiol) is associated with a minimal effect on hemostatic variables (increased Factor VII levels and higher activity of protein C and antithrombin). 8 The special and relative risk (in comparison to oral contraceptives) of thrombosis in patients using NuvaRing 1 is still unknown. Within this report, we report for the first time about thrombosis in a patient, using NuvaRing 1 as contraceptive.…”

Section: Discussionmentioning

confidence: 99%

Plantar Vein Thrombosis due to Busy Night Duty on Intensive Care Unit

Geiger

Rademacher

Chappell

et al. 2009

Clin Appl Thromb Hemost

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A 32-year-old woman with severe foot pain came to our emergency department after a busy night duty in hospital followed by an extended sleep period. Physical examination revealed a discrete swelling of the medial aspect of the right foot and a painful plantar arch during digital examination. Magnetic resonance imaging (MRI) with intravenous gadolinium showed filling defects in the lateral plantar vein. Doppler sonography displayed noncompressible structures in the plantar veins without flow signals, suggesting a plantar vein thrombosis. Therapy was initiated with low-molecular-weight heparin in combination with customized elastic bandages for the lower leg. Follow-up sonography 6 weeks later showed complete patency of the plantar veins. To our knowledge, we present the first case of isolated plantar vein thrombosis independent of trauma, surgery, or malignant disease, most probably caused by a busy night duty on the intensive care unit (ICU) followed by a prolonged sleeping period.

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The contraceptive vaginal ring (NuvaRing®) and hemostasis: a comparative study

Cited by 47 publications

References 13 publications

Contracepção hormonal e sistema cardiovascular

Contracepção hormonal e sistema cardiovascular

Oral Versus Vaginal Combined Hormonal Contraceptives' Effect on Coagulation and Inflammatory Biomarkers Among Young Adult Women

Plantar Vein Thrombosis due to Busy Night Duty on Intensive Care Unit

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