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Passage of the menopause is followed by haemostatic changes
C Lindoff1, F Petersson, I Lecander
1Department of Obstetrics and Gynaecology, University Hospital, Lund, Sweden.
Insights
Menopause increases cardiovascular disease (CVD) risk. Postmenopausal women show higher fibrinogen and plasminogen activator inhibitor-1 (PAI-1), potential CVD risk factors, despite maintained hemostatic balance.
Area of Science:
- Reproductive Endocrinology
- Cardiovascular Health
- Hemostasis and Thrombosis
Background:
- Menopause is associated with increased cardiovascular disease (CVD) risk.
- Alterations in coagulation and fibrinolytic factors are implicated in CVD development.
- Understanding these changes is crucial for risk assessment in postmenopausal women.
Purpose of the Study:
- To compare hemostatic variables between premenopausal and postmenopausal women.
- To investigate the impact of time since menopause on these variables.
- To identify potential risk factors for CVD in postmenopausal women.
Main Methods:
- Serum oestradiol, antithrombin III (AT III) activity, protein C activity, tissue type plasminogen activator (t-PA) antigen, plasminogen activator inhibitor-1 (PAI-1) antigen, and fibrinogen were measured.
- Participants were categorized into premenopausal (Group A), early postmenopausal (Group B, <18 months), and late postmenopausal (Group C, >18 months).
- Statistical comparisons were made between the groups.
Main Results:
- Group C exhibited significantly higher AT III and protein C activity compared to Group A.
- Significantly elevated t-PA and PAI-1 antigen levels were observed in Group C versus Group A.
- Both postmenopausal groups (B and C) demonstrated significantly higher fibrinogen concentrations than the premenopausal group (A).
Conclusions:
- Postmenopausal women may maintain hemostatic balance despite hormonal changes.
- Elevated fibrinogen and PAI-1 concentrations in postmenopausal women could represent significant risk factors for CVD.
- Further research is warranted to elucidate the long-term cardiovascular implications.
Abstract:
The passage of the menopause has been reported to be followed by a steadily increasing risk of cardiovascular disease (CVD). Changes in the concentrations of certain coagulation factors and fibrinolytic components are considered risk factors for CVD. We evaluated the differences in some of these variables between a premenopausal group (A) (n = 28) and two postmenopausal groups, one of women less than 18 months past the menopause (B) (n = 28), the other of women more than 18 months past the menopause (C) (n = 21). The variables measured were serum oestradiol content, plasma antithrombin III (AT III) activity, protein C activity and the plasma concentrations of tissue type plasminogen activator (t-PA) antigen, plasminogen activator inhibitor (PAI-1) antigen, and fibrinogen. As compared with the premenopausal women (group A), group C showed significantly higher values for AT III and protein C activity and for t-PA and PAI-1 antigen; and group B and C both showed significantly higher fibrinogen concentrations. This probably means that haemostatic balance was maintained in the postmenopausal women, although the increased concentrations of fibrinogen and PAI-1 might constitute risk factors for the development of cardiovascular disease.