Evidence for a Hypercoagulable State in Women With Ovarian Endometriomas

Endometriosis is a hormonal disease and also an inflammatory condition. Converging evidence indicates that inflammation and coagulation are 2 major host-defense systems that interact with each other. This study was undertaken to test the hypothesis that women with ovarian endometriomas are in a hypercoagulable state as manifested by the altered procoagulant factors and higher percentage of activated platelets in their peripheral blood. Two sets of participants were recruited. The first set consisted of 50 premenopausal women with endometriosis and 50 age-matched healthy women, and the second set consisted of 21 women with endometriosis and 17 age-comparable women without endometriosis. For the first set, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen, and other coagulation factors, along with their demographic, clinical, and anthropometric data, were measured/retrieved. For the second set, only the percentage of activated platelets in peripheral blood was evaluated. We found that women with endometriosis had a significantly shortened APTT and TT and elevated fibrinogen levels as compared with controls. They also had significantly higher percentage of circulating degranuated platelets, and the percentage was significantly reduced 1 month after surgical removal of endometriotic lesions. These findings provide evidence of a hypercoagulable state in women with endometriosis, reflecting the intimate relationship between coagulation and inflammation. They also suggest that these coagulation parameters such as APTT and fibrinogen and others could potentially be used for diagnostic or prognostic purposes. It also underpins the possibility for the use of antithrombotic therapy in the treatment of endometriosis.