THE EFFECT OF AN lNJECTABLE PROGESTOGEN CONTRACEPTIVE ON BLOOD COAGULATION AND FIBRINOLYSIS

Whigham, Kathryn A. E.; Howie, P. W.; Mack, A.; Prentice, C. R. M.

doi:10.1111/j.1471-0528.1979.tb10697.x

Cited by 16 publications

(5 citation statements)

References 12 publications

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“…The findings in this study disagrees with the findings of Mohamed et al, [13], who observed that there was no statistically significant difference in prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen and antithrombin, between users of injectable contraceptives and non-users of contraceptives. Also, there was no agreement with the study carried out by Whigham et al, [14], where they observed no statistically significant differences in antithrombin and fibrinogen. Additionally, the findings in this study is at variance with that of Joseph et al, [15], where they reported no statistically significant difference in platelet counts, prothrombin time and activated partial thromboplastin time between contraceptives users and non-users.…”

Section: Discussioncontrasting

confidence: 76%

“…The total study population consists of Seventyfive (75) apparently healthy, non-pregnant, nonsmoking women, aged between 25 and 45years. Forty-five (45) women on either DEPO-PROVERA (31) or Implanon (14) served as the test subjects while thirty (30) apparently healthy non-pregnant women of the same age bracket who never used hormonal contraceptive or any other family planning method, constituted the control group.…”

Section: Study Populationmentioning

confidence: 99%

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Investigation of the Possible Effects of Injectable and Skin Patch Contraceptives on Selected Haemostatic and Haematologic Parameters in Women Attending Primary Healthcare Centre in Eleme, Rivers State

Eze

Buseri

Christian

et al. 2020

JPRI

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The was a case control and comparative study aimed at investigating the possible effects of injectable and skin patch contraceptives on selected haematologic and haemostatic parameters in women attending primary healthcare centre at Eleme, Rivers State The study population consists of seventy-five (75) apparently healthy, non-pregnant, non- smoking women, aged between 25 and 45years; (31 women on DEPO-PROVERA contraceptive, 14 women on Implanon, and 30 apparently healthy non-contraceptive users as control group). Fibrinogen, antithrombin, tissue plasminogen activator was analysed with reagents prepared by Elabscience, Wuhan, China, using an ELISA machine (STAT FAX-2100). Prothrombin time and activated partial thromboplastin time was done manually with reagents prepared by Quimica Clinica Aplicada S.A, Spain. Haematologic parameters were analysed using SYSMEX KX-21-N auto analyser. Graph-pad Prism 5.0 was used in analysing all data, p < 0.05 was considered statistically significant. For haemostatic parameters, results showed that there was statistically significant increase in mean values of antithrombin (38.48 ± 17.48/ml versus 21.02 ± 15.54ng/ml, p=0.0011) and tissue plasminogen activator (1.34 ± 1.35ng/ml versus 0.28 ± 0.46ng/ml, p=0.0047) in women using the two types of contraceptive, while activated partial thromboplastin time (28.11± 2.37s versus 29.87 ± 2.77s, p=0.0205) was statistically decreased in women on the investigated contraceptives, other haemostatic parameters were not statistically significant. For haematological parameters, the results showed that there was statistically significant increase in mean values of packed cell volume 38.13 ± 2.28% versus 36.21 ± 3.07% (p=0.0126), haemoglobin 12.35 ± 0.79g/dL versus 11.56 ± 0.99g/dL (p=0.0028), white blood cells 6.17 ± 1.22 x109/L versus 5.26 ± 1.18 x109/L (p=0.0143) in women using injectable (DEPO-PROVERA) and skin patch (IMPLANON) contraceptive, other parameters showed no statistically significance. Based on duration of use of contraceptive, there was no statistically significant difference (p>0.05) in women using skin patch; while for injectable, platelet count was high in those who had used it for more than a year. Comparing values obtained from using injectable and skin patch, there was no statistical significant difference in all the parameters. Using analysis of variance to compare values based on parity, there was no statistical significant difference. Conclusively, increase in antithrombin and tissue plasminogen activator, and a decrease in activated partial thromboplastin time in women using IMPLANON (skin patch) and DEPO-PROVERA (injectable) are the haemostatic changes that occurs while using contraceptives and these changes may likely predispose them to bleeding, therefore adequate monitoring of the blood haemostatic processes while taking these contraceptives is critical in order not to expose users to haemorrhage.

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Section: Discussioncontrasting

confidence: 76%

Section: Study Populationmentioning

confidence: 99%

Investigation of the Possible Effects of Injectable and Skin Patch Contraceptives on Selected Haemostatic and Haematologic Parameters in Women Attending Primary Healthcare Centre in Eleme, Rivers State

Eze

Buseri

Christian

et al. 2020

JPRI

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“…Oral contraceptives with the highest risks of venous thrombosis were also associated with the highest levels of SHBG and SHBG levels were positively associated with resistance to activated protein C. 15,16 Therefore, because SHBG levels have been seen as a potentially useful marker for the risk of venous thrombosis, a decrease in SHBG associated with injectable DMPA-only contraceptives, as reported by Walsh et al, 9 suggests that these contraceptives are not associated with an increased risk of venous thrombosis, contrary to our findings. However, other studies 8,17,18 on the effect of DMPA contraceptives showed little or no effect on coagulation or inflammation markers.…”

Section: Discussionmentioning

confidence: 98%

The Risk of Deep Venous Thrombosis Associated With Injectable Depot–Medroxyprogesterone Acetate Contraceptives or a Levonorgestrel Intrauterine Device

Vlieg

Helmerhorst

Rosendaal

2010

ATVB

153

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Objective-To assess the risk of venous thrombosis associated with nonoral contraceptives (ie, injectable depot-medroxyprogesterone acetate contraceptives, hormone [levonorgestrel]-releasing intrauterine devices, a contraceptive patch, or a contraceptive implant). Methods and Results-Analyses were performed in the Multiple Environmental and Genetic Assessment study, a large case-control study on risk factors for venous thrombosis. For the current analyses, we selected premenopausal women, aged 18 to 50 years, who were not pregnant nor within 4 weeks postpartum and were not using oral contraceptives; 446 patients and 1146 controls were included. Injectable depot-medroxyprogesterone acetate contraceptives were associated with a 3.6-fold (95% CI, 1.8-to 7.1-fold) increased risk of venous thrombosis compared with nonusers of hormonal contraceptives. The use of a levonorgestrel intrauterine device was not associated with an increased risk (odds ratio, 0.3; 95% CI, 0.1 to 1.1). Unfortunately, the few women using a contraceptive patch or an implant prevented a reliable estimate of the risk of thrombosis. Conclusion-The risk of venous thrombosis was increased for injectable depot-medroxyprogesterone acetate contraceptive users, while we were able to reliably exclude an increased risk associated with levonorgestrel intrauterine device use. Therefore, the latter seems to be the safest option regarding the risk of venous thrombosis. O ral contraceptive use is a well-established risk factor for the development of a first deep venous thrombosis, with risk estimates ranging from a 2-to 6-fold increased risk for users compared with nonusers. [1][2][3][4] Combined oral contraceptive preparations contain an estrogen (generally ethinyloestradiol) and a progestogen. The increased risk of venous thrombosis associated with combined preparations was mainly attributed to the estrogen component of the contraceptive. However, the progestogen component alone or in combination with ethinyloestradiol has also been associated with the risk of venous thrombosis. Different types of progestogens in combined preparations yield a different risk of deep venous thrombosis, with the highest risk associated with the third-generation progestogen desogestrel and the more recently introduced progestogens cyproterone acetate and drospirenone. 5,6 Although there has been much research regarding combined oral contraceptives, few data are available on the risk of venous thrombosis associated with hormonal contraceptives with other routes of administration (eg, transdermal or intrauterine).Depot-medroxyprogesterone acetate (DMPA) is a longacting injectable progestogen-only contraceptive. In 1998, the World Health Organization reported a small increased risk of venous thrombosis for women using injectable progestogenonly contraceptives (odds ratio [OR], 2.2; 95% CI, 0.7 to 7.3). 7 In contrast, Goldstein et al 8 performed a study on the risk of venous thrombosis associated with injectable progestogen-only contraceptives, using surrogate end points (eg, coagula...

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“…However, effects on the vessel wall by estrogens and progestogens have also been reported (4, 18), (19). Such effects may depend on the type and dose of the progestogen, the route of administration, the duration of exposure, and, when combined with estrogens, the type and dose of the estrogen (20), (21). It is disputed to what extent progestogens may affect primary hemostasis and platelet aggregation.…”

Section: Discussionmentioning

confidence: 99%

Limited knowledge on progestogen‐only contraception and risk of venous thromboembolism

Bergendal

Odlind

Persson

et al. 2009

Acta Obstet Gynecol Scand

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THE EFFECT OF AN lNJECTABLE PROGESTOGEN CONTRACEPTIVE ON BLOOD COAGULATION AND FIBRINOLYSIS

Cited by 16 publications

References 12 publications

Investigation of the Possible Effects of Injectable and Skin Patch Contraceptives on Selected Haemostatic and Haematologic Parameters in Women Attending Primary Healthcare Centre in Eleme, Rivers State

Investigation of the Possible Effects of Injectable and Skin Patch Contraceptives on Selected Haemostatic and Haematologic Parameters in Women Attending Primary Healthcare Centre in Eleme, Rivers State

The Risk of Deep Venous Thrombosis Associated With Injectable Depot–Medroxyprogesterone Acetate Contraceptives or a Levonorgestrel Intrauterine Device

Limited knowledge on progestogen‐only contraception and risk of venous thromboembolism

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