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Published on: March 19, 2016
Impact of progestogens on hemostasis
Sven O Skouby1, Johannes J Sidelmann2
1Reproductive Medicine Unit, Department of Obstetrics and Gynecology, Herlev/Gentofte Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, Phone: +45 38683796, Secretary: +45 38688272.
Hormonal therapies containing estrogen and progestogen increase venous thrombosis risk. Progestogens primarily affect platelet function and coagulation, influencing hemostasis.
Area of Science:
- Pharmacology
- Hematology
- Endocrinology
Background:
- Combined hormonal contraceptives and postmenopausal hormone therapy are linked to venous thrombosis.
- Thrombotic risk is influenced by estrogen dose and progestogen type.
Purpose of the Study:
- To review the pharmacodynamics of progestogens on the hemostatic system.
- To analyze existing data from animal, cell culture, and clinical studies.
Main Methods:
- Literature review of studies on progestogen effects on hemostasis.
- Analysis of data from in vivo and in vitro experiments.
- Examination of studies involving progestogen-only and combined contraceptives.
Main Results:
- Progestogens significantly alter platelet function and the tissue factor pathway of coagulation.
- Data from combined contraceptives suggest progestogen influence, but extrapolation is challenging.
- Limited clinical data exist for progestogen-only therapy effects on hemostasis.
Conclusions:
- Progestogens exert major effects on hemostasis via platelet and coagulation pathways.
- Further research is needed to clarify progestogen-only therapy impacts on thrombosis risk.
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