Comparative study of the effects of two once-a-month injectable contraceptives (Cyclofem and Mesigyna) and one oral contraceptive (Ortho-Novum 1/35) on coagulation and fibrinolysis.

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Comparative study of the effects of two once-a-month injectable contraceptives (Cyclofem and Mesigyna) and one oral contraceptive (Ortho-Novum 1/35) on coagulation and fibrinolysis.

Contraception. 2003 Sep;68(3):159-76.

PubMed ID
14561536 [ View in PubMed
]
Abstract

A randomized controlled multicenter study was undertaken to monitor the effects on hemostasis of two once-a-month injectable contraceptive preparations, Mesigyna (50 mg norethisterone enanthate and 5 mg estradiol valerate) and Cyclofem (25 mg medroxyprogesterone acetate and 5 mg estradiol cypionate) in comparison with a well-known oral contraceptive (OC) Ortho-Novum 1/35 (norethisterone 1 mg and ethinyl estradiol 35 microg). A total of 378 volunteers from four centers (Bangkok, Hangzhou, Santiago and Singapore) were monitored. Blood sampling took place in one pretreatment cycle, the third and ninth injection intervals and one posttreatment cycle. In each of the three treatment groups, a rise in hemoglobin, and increases in platelet count and in prothrombin time were observed. With treatment there was a significant increase in activated partial thromboplastin time among Mesigyna users, no change among Cyclofem users and a significant decrease among OC users. OC use led to increases in plasma levels of fibrinogen, factor VII, factor X, plasminogen, protein C and decreases in plasma levels of t-PAI and antithrombin. Use of combined injectables induced no change (Cyclofem) or decreases (Mesigyna) in plasma levels of fibrinogen, factor VII, factor X and antithrombin. Use of both combined injectables led to decreases in protein C, slight decreases in plasminogen and increases in plasminogen and fibrinogen. Overall, the injectable preparations may be more beneficial than the oral preparation in not enhancing a hypercoagulable state because of the reduced synthesis of fibrinogen, factors VII and X; however, decreases in antithrombin and protein C, which are potent coagulation inhibitors, may raise some concern. Whether these changes can lead to modifications in the risk of arterial or venous disease can only be ascertained by conducting epidemiological studies.

DrugBank Data that Cites this Article

Pharmaco-proteomics
DrugDrug GroupsGeneGene IDChangeInteractionChromosome
EthinylestradiolApprovedSERPINC1462
decreased
[Ethinyl Estradiol binds to Norethindrone] which results in decreased expression of SERPINC1 protein1q25.1
NorethisteroneApprovedSERPINC1462
decreased
[Ethinyl Estradiol binds to Norethindrone] which results in decreased expression of SERPINC1 protein1q25.1
EthinylestradiolApprovedSERPINE15054
decreased
[Ethinyl Estradiol binds to Norethindrone] which results in decreased expression of SERPINE1 protein7q22.1
NorethisteroneApprovedSERPINE15054
decreased
[Ethinyl Estradiol binds to Norethindrone] which results in decreased expression of SERPINE1 protein7q22.1
EthinylestradiolApprovedF102159
increased
[Ethinyl Estradiol binds to Norethindrone] which results in increased expression of F10 protein13q34
NorethisteroneApprovedF102159
increased
[Ethinyl Estradiol binds to Norethindrone] which results in increased expression of F10 protein13q34
EthinylestradiolApprovedF72155
increased
[Ethinyl Estradiol binds to Norethindrone] which results in increased expression of F7 protein13q34
NorethisteroneApprovedF72155
increased
[Ethinyl Estradiol binds to Norethindrone] which results in increased expression of F7 protein13q34
EthinylestradiolApprovedPLG5340
increased
[Ethinyl Estradiol binds to Norethindrone] which results in increased expression of PLG protein6q26
NorethisteroneApprovedPLG5340
increased
[Ethinyl Estradiol binds to Norethindrone] which results in increased expression of PLG protein6q26
EthinylestradiolApprovedPROC5624
increased
[Ethinyl Estradiol binds to Norethindrone] which results in increased expression of PROC protein2q14.3
NorethisteroneApprovedPROC5624
increased
[Ethinyl Estradiol binds to Norethindrone] which results in increased expression of PROC protein2q14.3