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Endometrial fibrinolytic enzymes in women with normal menstruation and dysfunctional uterine bleeding
N Gleeson1, M Devitt, B L Sheppard
1Trinity College Department of Obstetrics & Gynaecology, St James's Hospital, Dublin.
Objective:
To study fibrinolysis in the endometrium in women with normal menstruation and dysfunctional uterine bleeding (DUB).
Design:
Tissue plasminogen activator activity (t-PA) and antigen (t-PAAg) and plasminogen activator inhibitor Type 1 antigen (PAI-1) were measured in homogenates of endometrium sampled between 24 and 36 h after the onset of menstruation.
Subjects:
Women complaining of menorrhagia who had negative findings at clinical examination and curettage had their menstrual blood loss (MBL) measured from the third cycle after D&C. Those with MBL greater than 80 ml per cycle formed the DUB group.
Measurements:
Fibrinolytic enzyme antigen levels were measured with ELISAs. Tissue plasminogen activator activity was assayed by measuring the rate of conversion of Glu-plasminogen to plasmin, using a chromogenic plasmin substrate.
Conclusions:
There is a strong positive correlation between endometrial t-PA activity on the second day of menstruation and measured menstrual loss (P < 0.05). Concentrations of endometrial t-PAAg and PAI-1 antigen are higher in women with DUB compared with normal women during menstruation.