Hormone replacement therapy and hemostasis: Effects in Brazilian postmenopausal women

Abstract

Objective To evaluate the impact that administration of transdermal estradiol gel combined with medroxyprogesterone acetate (MPA) has on hemostasis. Methods In this open prospective longitudinal study, thirty postmenopausal women received transdermal estradiol gel (1 mg/day) continuously combined with oral MPA (5 mg/day) for 12 days/month. The following parameters were determined: prothrombin time (PT), activated partial thromboplastin time (aPTT), factors VII, X, and XII activity, fibrinogen levels, thrombin-antithrombin complex levels, protein C and S antigen, antithrombin activity, plasminogen activator inhibitor type 1 (PAI-1) antigen, tissue-type plasminogen activator (t-PA) antigen, plasminogen activity and fibrin degradation products (FbDP) antigen. They were evaluated before and after 6 months of treatment. Results There was a significant decrease in factor VII activity ( P = 0.001), factor X activity ( P = 0.016), protein C antigen ( P = 0.022), antithrombin activity ( P = 0.025), plasminogen activity ( P = 0.023), t-PA antigen ( P = 0.043) and FbDP antigen ( P = 0.048) compared with baseline values. Conclusion The results suggest that the treatment with transdermal estradiol gel combined with MPA avoids any major activation of coagulation and does not produce any overall effect on fibrinolysis. Therefore, this treatment might provide interesting effects on hemostasis in postmenopausal Brazilian women.