Coagulation and fibrinolysis in estrogen-treated surgically menopausal women

The short-term effects of different types and doses of estrogen therapy on coagulation and fibrinolysis were studied in 35 surgically menopausal women. Dynamic tests of the coagulation cascade, tests indicative of ongoing, intravascular coagulation, and assessments of coagulation inhibition and fibrinolysis were performed. No clinically abnormal responses were found with the tested regimens--1 and 2 mg of 17 beta-estradiol and 0.625 and 1.25 mg of conjugated equine estrogens. Increased plasminogen antigen and activity were found with the conjugated estrogens but not with the 17 beta-estradiol preparations. The age of the woman had no effect on either the direction or magnitude of response to treatment. Estrogen therapy at the reported doses does not appear to adversely affect the coagulation-fibrinolysis systems of surgically menopausal women. Based on their ability to enhance plasminogen activity, conjugated estrogens may be preferred over the 17 beta-estradiol preparations for this clinical population.