Abstract
During menstruation, endometrial hemostasis is achieved by platelet aggregation, fibrin deposition, and thrombus formation that interact with local endocrine and immunological factors which cause termination of menstrual bleeding. Interactions between steroidal sex hormones and platelet functions are not well understood. The aim of this study was to evaluate the effect of platelet function during the menstrual cycle and luteal phase in women of reproductive age. The cross-sectional study on women of reproductive age included 44 healthy women. Platelet function was assessed by PFA-100TM analyzer with collagen/epinephrine and collagen/ADP cartridges during the menstrual cycle and luteal phase. There were no significant differences in platelet function between menstruation and ovulatory phase. Platelet activity in Arab collagen/epinephrine cartridge increased during menstruation compared to non-Arab ethnic subjects and no significant differences in platelet function were found when using collagen/ADP cartridge. This study suggested modulation in platelet functions during menstruation and luteal phase in women of reproductive age. Further studies, including a large number of subjects, platelet genetic and progesterone factors change in platelet clotting associated to menstrual cycle should be conducted.
Highlights
There are many controversies about the exact mechanism of steroid hormones on hemostasis during the ovarian cycle, pregnancy, and hormone replacement therapy (HRT)
The current study suggested that platelet function modulation enhanced during menstruation and luteal phase of the menstrual cycle in reproductive age and the 17β-estradiol had a role in platelets behavior and was affected by different factors such as the type of agonist and race
A similar study must be conducted on a larger sample size in the Arab population and with more precise tests of platelet function and closure time studies, prothrombin time, activated partial thromboplastin time, and coagulation factor assays
Summary
There are many controversies about the exact mechanism of steroid hormones on hemostasis during the ovarian cycle, pregnancy, and hormone replacement therapy (HRT). Normal menstruation starts with a marked decrease in progesterone and estrogen hormones where the cessation of menstrual bleeding is achieved by endometrial hemostasis through platelet aggregation, deposition of fibrin and thrombus formation [1]. The variation in platelet function was reported due to progesterone and estrogen at von Willebrand disease (vWF) concentrations [4]. The platelet activity was more during the luteal phase in collagen/epinephrine cartridge compared with the follicular phase. Et al [5] reported that platelet activation was increased in collagen/epinephrine cartridge during luteal phase compared to the follicular phase in women who are not pill users, due to variability in progesterone level during ovarian cycle phases. The main aim of this study is to determine the platelet function modulation during the menstrual cycle and luteal phase in women of reproductive age
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