RESEARCH PAPER
Effect of transdermal hormone therapy on platelet haemostasis in menopausal women
1
Department Gynecology and Gynecologic Oncology, Polish Mother’s Memorial Hospital-Research Institute, Lodz, Poland
2
Nicolaus Copernicus Memorial Hospital, Lodz, Poland
3
Independent Consultant, London, United Kingdom
Corresponding author
Grzegorz Stachowiak
Department Gynecology and Gynecologic Oncology, Polish Mother’s Memorial Hospital-Research Institute, 281/289 Rzgowska St. 93-338 Lodz, Poland
Department Gynecology and Gynecologic Oncology, Polish Mother’s Memorial Hospital-Research Institute, 281/289 Rzgowska St. 93-338 Lodz, Poland
Ann Agric Environ Med. 2015;22(1):167-171
KEYWORDS
ABSTRACT
Introduction:
Despite the undeniably positive effect on the quality of life of menopausal women, menopausal hormone therapy (HT) also has negative side-effects, which include, among others, thromboembolic complications. Objective.To assess the effect of a popular type of this therapy – transdermal HT on platelet hemostasis, which plays a significant role in intravascular coagulation.
Material and Methods:
The study group consisted of 92 postmenopausal women: 1) group G1 (n=30), treated with transdermal HT (17β-estradiol 50 μg/day plus NETA 170 μg/day); 2) group G2 (n=31), treated with the above transdermal HT and low dosage of acetylsalicylic acid (ASA); 3) control group P (n=31). All the women qualified for the study had two or more risk factors for arterial thrombosis, such as: smoking, hypertension, visceral obesity, hypercholesterolaemia, hypertriglyceridaemia, elevated levels of PAI-1, and increased fibrinogen, increased activity of coagulation factor VII.
Results:
After three months of therapy, in the G1 group there was a decrease in platelet count (p = 0.004) and a decrease in GP IIb/IIIa – a platelet receptor for fibrinogen (p = 0.022). In the G2 group, no changes in the tested parameters were observed.
Conclusions:
1) Transdermal HT in the form of combined, estrogen-progestogen patches favourably modifies platelets haemostasis, reversing the adverse effects that occur after menopause. 2) The use of low ASA doses as a thromboprophylaxis in short-term transdermal HT is not necessary.
Despite the undeniably positive effect on the quality of life of menopausal women, menopausal hormone therapy (HT) also has negative side-effects, which include, among others, thromboembolic complications. Objective.To assess the effect of a popular type of this therapy – transdermal HT on platelet hemostasis, which plays a significant role in intravascular coagulation.
Material and Methods:
The study group consisted of 92 postmenopausal women: 1) group G1 (n=30), treated with transdermal HT (17β-estradiol 50 μg/day plus NETA 170 μg/day); 2) group G2 (n=31), treated with the above transdermal HT and low dosage of acetylsalicylic acid (ASA); 3) control group P (n=31). All the women qualified for the study had two or more risk factors for arterial thrombosis, such as: smoking, hypertension, visceral obesity, hypercholesterolaemia, hypertriglyceridaemia, elevated levels of PAI-1, and increased fibrinogen, increased activity of coagulation factor VII.
Results:
After three months of therapy, in the G1 group there was a decrease in platelet count (p = 0.004) and a decrease in GP IIb/IIIa – a platelet receptor for fibrinogen (p = 0.022). In the G2 group, no changes in the tested parameters were observed.
Conclusions:
1) Transdermal HT in the form of combined, estrogen-progestogen patches favourably modifies platelets haemostasis, reversing the adverse effects that occur after menopause. 2) The use of low ASA doses as a thromboprophylaxis in short-term transdermal HT is not necessary.
REFERENCES (30)
1.
The 2012 Hormone Therapy Position Statement of the North American Menopause Society. Menopause 2012; 19(3): 257–271.
2.
Bojar I, Biliński P, Boyle P, Zatoński W, Marcinkowski JT, Wojtyła A. Prevention of female reproductive system cancer among rural and urban Polish pregnant women. Ann Agric Environ Med. 2011; 18: 183–188.
3.
Krzyżak M, Maślach D, Juczewska M, Lasota W, Rabczenko D, Marcinkowski JT, Szpak A. Differences in breast cancer incidence and stage distribution between urban and rural female population in Podlaskie Voivodship. Poland in years 2001–2002. Ann Agric Environ Med. 2010; 17: 159–162.
4.
Krzyżak M, Maślach D, Bielska-Lasota M, Juczewska M, Rabczenko D, Marcinkowski JT, Szpak A. Breast cancer survival gap between urban and rural female population in Podlaskie Voivodship, Poland, in 2001–2002. Population study. Ann Agric Environ Med. 2010; 17: 277–282.
5.
Stachowiak G, Pertyński T. Najnowsze doniesienia dotyczące bezpieczeństwa hormonalnej terapii zastępczej dla układu sercowo-naczyniowego. Prz Menopauzalny. 2012; 1: 1–4 (in Polish).
6.
Rosano G, Vitale C, Spoletini I, Fini M. Cardiovascular health in the menopausal woman: impact of the timing of hormone replacement therapy. Climacteric 2012; 15: 299–305.
7.
Pertyński T, Stachowiak G. Przezskórna terapia okresu menopauzy – state of the art in 2010. Prz Menopauzalny 2010; 2: 71–77 (in Polish).
8.
Plow EF, Ginsberg MH. The molecular basis for platelet function. In: Hoffman R, Benz EJ, Shattil SJ, Furie B, Cohen HJ, Silberstein P, McGlave P. Hematology. Basic principles and practice. Churchill Livingstone. New York, Edinburgh, Londyn. Philadelphia, San Francisco, 2000.pp.1741–1752.
9.
A language and environment for statistical computing (2007). R Foundation for Statistical Computing. Vienna. Austria http://www. R-project.org (access: 2102.11.09).
10.
Stachowiak G, Pertyński T. Bezpieczeństwo kardiologiczne terapii hormonalnych okresu menopauzy. Prz Menopauzalny. 2009; 6: 315–319 (in Polish).
11.
Paszkowski T, Sikorski R, Jakiel G. Medycyna menopauzalna u progu trzeciego tysiąclecia. Ginekol Pol. 2002; 72(12A): 1370–1376 (in Polish).
12.
Rzymski P, Opala T. Elastography as a new diagnostic tool to detect breast cancer – evaluation of research and clinical applications. Prz. Menopauzalny. 2011; 5: 357–362.
13.
Stachowiak G, Faflik U, Stetkiewicz F, Pertyński T. Cardiovascular diseases in women – impact of the menopausal period. Prz Menopauzalny. 2006; 6: 382–387.
14.
Humeniuk E, Bojar I, Owoc A, Wojtyła A, Fronczak A. Psychosocial conditioning of depressive disorders in post-menopausal women. Ann Agric Environ Med. 2011; 18(2): 441–445.
15.
Stachowiak G, Połać I, Jędrzejczyk S, et al. Postmenopausal status, coagulation and fibrinolysis. Pol J Gynaecol Invest. 2001; 3: 97–100.
16.
Peverill RE, Smolich JJ, Malan E, et al. Comparison of effects of pravastatin and hormone therapy on soluble P-selectin and platelet P-selectin expression In postmenopausal hypercholesterolemic women. Maturitas 2006; 53: 158–165.
17.
Oliveira RL, Aldrighi JM, Gebara OE, et al. Postmenopausal hormone replacement therapy increases plasmatic thromboxane beta 2. Int J Cardiol. 2005; 99: 449–454.
18.
Thijs A, van Baal WM, van der Mooren MJ, et al. Effects of hormone replacement therapy on blood platelets. Eur J Clin Invest. 2002; 32: 613–618.
19.
Teede HJ, McGrath BP, Turner A, et al. Effects of oral combined hormone replacement therapy on platelet aggregation In postmenopausal women. Clin Sci (Lond). 2001; 100: 207–213.
20.
Ranganath LR.Christofides J. Semple MJ. Increased mean platelet volume after estrogen replacement therapy. Ann Clin Biochem. 1996; 33: 555–560.
21.
Traquilli AL, Mazzanti L, Cugini AM, et al. Transdermal estradiol and medroxyprogesterone acetate in hormone replacement therapy are both antioxidants. Gynecol Endocrinol. 1995; 9: 137–141.
22.
Garcia-Martinez MC, Labios M, Hermenegildo C, et al. The effect of hormone replacement therapy on Ca2+ mobilization and P-selectin (CD62P) expression in platelets examined under flow cytometry. Blood Coagul Fibrinolysis. 2004; 15: 1–8.
23.
Martina V, Bruno GA, Origlia C, et al. Transdermal oestradiol replacement therapy enhances platelet constitutive nitric oxide synthase activity In postmenopausal women with type 2 diabetes mellitus. Clin Endocrinol (Oxf). 2002; 57: 371–375.
24.
Hulley S, Grady D, Bush T, et al. For the Heart and Estrogen/Progestin Replacement Study (HERS) Research Group. Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. JAMA 1998; 280: 605–613.
25.
Writing group for the women’s health initiative investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women. Principal results from the women’s health initiative randomized controlled trial. JAMA 2002; 288: 321–333.
26.
Grodstein F, Manson JE, Stampfer MJ. Hormone therapy and coronary heart disease: the role of time since menopause and age at hormone initiation. J Womens Health. 2006; 15: 35–44.
27.
Rossouw JE, Prentice RL, Mason JE, et al. Postmenopausal Hormone Therapy and Risk of Cardiovascular Disease by Age and Years Since Menopause. JAMA 2007; 297: 1465–1477.
28.
Skrzypulec V, Drosdzol A, Ferensowicz J. Ocena jakości życia kobiet w okresie klimakterium. Ginekol Pol. 2004; 75(5): 373–381 (in Polish).
29.
Żołnierczuk-Kieliszek D, Kulik TB, Jarosz MJ, Stefanowicz A, Pacian A, Pacian J, Janiszewska M. Quality of life in peri- and post-menopausal Polish women living in Lublin Province – differences between urban and rural dwellers. Ann Agric Environ Med. 2012; 19(1): 129–133.
30.
Stachowiak G, Tomasz Pertyński T. Bezpieczeństwo zakrzepowo-zatorowe przezskórnej terapii hormonalnej. Prz Menopauzalny. 2008; 6: 285–290 (in Polish).
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