THE EFFECTS OF TRANSDERMAL ESTRADIOL AND ORAL PROGESTOGENS ON HEMOSTASIS VARIABLES

Objective To evaluate the effects of 1 g (1 mg oestradiol) transdermal oestradiol gel continuously combined with 10 mg medroxyprogesterone a cetate orally 12 days either monthly or every third month on haemostas is variables. Design An open, parallel stratified study. Setting Sahlg renska University Hospital, Goteborg, Sweden Participants A total of 4 8 peri- and postmenopausal women less than 65 years of age participate d in this study. Twenty-seven women, who had from 2 months to 3 years since their last period were included in group I. Twenty-one women, wh o were more than 3 years postmenopausal, comprised group II. Main outc ome measures The following parameters were determined: von Willebrand factor antigen, factor VII antigen, fibrinogen, antithrombin, protein C, protein S, plasminogen activator inhibitor activity, tissue plasmin ogen activator antigen, prothrombin fragment(1+2), thrombin-antithromb in complex and platelets. Results Both regimens decreased fibrinogen, factor VII antigen as well as antithrombin. Conclusions These changes were mainly 'in an anti-thrombotic direction'. The overall impression is that the transdermally administered oestrogen in combination with a n oral progestogen induced favourable, although slight changes in the haemostatic system. The possible influence of these changes on the ris k of cardiovascular disease remains yet to be studied.