THE EFFECTS OF TRANSDERMAL ESTRADIOL AND ORAL CONJUGATED ESTROGENS ONHEMOSTASIS VARIABLES

The effects of oral and transdermal administration of estrogen replace ment therapy (ERT) have been fairly well investigated regarding lipopr otein and carbohydrate metabolism, while the effects of different mode s of estrogen administration on the haemostatic system have been less well studied. To delineate and compare the effects of perorally admini stered conjugated estrogens (CE) and transdermally administered estrad iol (E(2)) in doses needed for hormone replacement therapy (HRT) on ha emostasis parameters, 23 postmenopausal women were engaged in a study with an open cross-over design. The doses compared (0.625 mg CE and 50 mu g E(2)/24h) are the lowest which, with few exceptions, eliminate c limacteric symptoms. Both CE and E(2) increased factor VII:C, factor V II:Ag, and the prothrombin fragment(1+2). The increase in factor VII:A g, however, was significantly higher after treatment with CE. These ch anges were all towards a state of hypercoagulability. Furthermore, CE decreased plasminogen activator inhibitor (PAI) and the thrombin-antit hrombin complexes (TAT), as well as antithrombin (ATIII).