A comparative study on the effects of a monophasic pill containing desogestrel plus 20 μg ethinylestradiol, a triphasic combination containing levonorgestrel and a monophasic combination containing gestodene on coagulatory factors

Melis, G. B.; Fruzzetti, Franca; Nicoletti, Ildo; Ricci, Cabiria; Lammers, Paul; Atsma, Willem Jan; Fioretti, P.

doi:10.1016/0010-7824(91)90123-w

Cited by 45 publications

(10 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This increase, in conjunction with the increased levels of clotting factors, represents an increase in the potential for fibrin production. Studies of markers of coagulation end‐points such as fibrinopeptide A suggest that increased activation of the coagulation system does occur in oral contraceptive users 24–26 but that this increase is also influenced by the oestrogen component 26 . The level of fibrinopeptide A is unchanged in women taking 20 μg EE/DES but increased in women taking combinations containing 30 μg EE 26 .…”

Section: Discussionmentioning

confidence: 99%

The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives

Norris

Bonnar

1996

BJOG

View full text Add to dashboard Cite

Objective To determine the effect of oestrogen dose and progestogen type on the coagulation and fibrinolytic systems of a group of normal healthy women taking three different oral contraceptive combinations. Design Plasma levels of factor VII, X, antithrombin III, protein C, fibrinogen, tissue plasminogen activator activity, plasminogen activator inhibitor I antigen and fibrin (D‐dimer) degradation products were measured at pretreatment, 6, 14, 22 weeks of treatment and at 6 weeks post‐treatment in a group of 67 women taking either 30 μg ethinyloestradiol/150 μg desogestrel (n= 21), 20 μg ethinyloestradiol/150 μg desogestrel (n= 24), 30 μg ethinyloestradiol/75 μg gestodene (n= 22). Participants Sixty‐seven healthy normal women, 18 to 34 years, smoking fewer than 15 cigarettes per day. The subjects were within 10% of their normal body weight and had no history of thromboembolic disease. Setting Coombe Women's Hospital and St James's Hospital, Dublin, Ireland. Results Factor VII and X levels were significantly raised on treatment with both the 30 μg ethinyloestradiol/desogestrel and gestodene combinations. Higher levels of factor VII activity were observed in the 30 μg ethinyloestradiol/desogestrel combination compared with the gestodene combination. Factor VII and X were not significantly affected by the 20 μg ethinyloestradiol combination. Increased plasminogen, fibrinogen and D‐dimer levels and decreased plasminogen activator inhibitor 1 antigen levels were observed during the treatment phases in all three groups. Antithrombin TI1 and protein C activity did not change during treatment with any of the oral contraceptives studied. Conclusions Low dose oral contraceptives cause an activation of the coagulation system which is balanced by an activation of the fibrinolytic system. Reducing the dose of ethinyloestradiol from 30 μg to 20 μg reduces the effect on factor VII and X. This effect can be modified by the progestogen. The lesser effect of the 20 μg combination may make this a safer option for some women than pills containing a higher dose of oestrogen.

show abstract

Section: Discussionmentioning

confidence: 99%

The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives

Norris

Bonnar

1996

BJOG

View full text Add to dashboard Cite

show abstract

“…Table 3 illustrates the effects of COCs containing desogestrel, gestodene monophasic and triphasic, and the triphasic levonorgestrel preparations on the haemostatic system (Rakoczi 1985; Bruni 1986; Bonnar 1982; Bonnar 1987; Bonnar etal. 1987; Cohen 1988; Fioretti 1989; Kjaer 1989; Omsjo 1989; Abbate 1990; Ball 1990; Daly 1990; Daume 1990; David 1990; Jespersen 1990; Refn 1990; Robinson 1990; Melis 1991).…”

Section: Haemostatic Changesmentioning

confidence: 99%

Low‐dose combined oral contraceptives

Robinson

1994

BJOG

View full text Add to dashboard Cite

“…Using a lower dose of EE may help to ameliorate this risk and reduce the adverse effects associated with the estrogen component of COCs [16]. While there is some evidence that COCs containing lower doses of EE are associated with fewer negative hemostatic effects [17], the role of third-generation progestins constitutes a source of continuing debate. Although there have been attempts to predict VTE risk through the evaluation of changes occurring in the coagulatory system, these surrogate parameters are not generally accepted.…”

Section: Introductionmentioning

confidence: 99%

Investigation of the Hemostatic Effect of a Transdermal Patch Containing 0.55 mg Ethinyl Estradiol and 2.1 mg Gestodene Compared with a Monophasic Oral Contraceptive Containing 0.03 mg Ethinyl Estradiol and 0.15 mg Levonorgestrel: An Open-Label, Randomized, Crossover Study

Junge¹,

Heger-Mahn

Trummer

et al. 2013

Drugs R D

View full text Add to dashboard Cite

BackgroundTransdermal delivery of contraceptives offers several advantages over combined oral contraceptives (COCs), including effective absorption and the provision of relatively constant serum concentrations. Ethinyl estradiol (EE) and the progestin gestodene are well-absorbed through the skin and, therefore, well-suited for use in a transdermal contraceptive patch.ObjectiveThe objective of this study was to investigate the impact of a once-weekly transparent, transdermal patch delivering low doses of EE and gestodene equivalent to a COC containing 0.02 mg EE and 0.06 mg gestodene on hemostasis parameters compared with a monophasic COC containing 0.03 mg EE and 0.15 mg levonorgestrel.MethodsIn this single-center, open-label, randomized, crossover study, 30 women (aged 18–35 years) received three cycles of each treatment, separated by a two-cycle washout period. The primary outcome measure was the absolute change from baseline in prothrombin fragments 1 + 2 and d-dimer.ResultsFor both treatments, prothrombin fragments 1 + 2 remained stable during the first treatment period, and increased only slightly in the second period (mean absolute change 0.025 and 0.028 nmol/L in the novel Bayer patch and COC groups, respectively). Increases in d-dimer were observed in both periods (mean absolute change 107.0 ± 147.2 ng/L for the novel Bayer patch and 113.7 ± 159.0 ng/L for the COC). There were no statistically significant treatment differences in prothrombin 1 + 2 or d-dimer (p = 0.667 and p = 0.884, respectively) and no statistically significant treatment sequence or period effects.ConclusionA COC containing 0.03 mg EE and 0.15 mg levonorgestrel and the novel Bayer patch have comparable influence on hemostatic endpoints. Both treatments were well-tolerated by subjects.

show abstract

A comparative study on the effects of a monophasic pill containing desogestrel plus 20 μg ethinylestradiol, a triphasic combination containing levonorgestrel and a monophasic combination containing gestodene on coagulatory factors

Cited by 45 publications

References 17 publications

The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives

The effect of oestrogen dose and progestogen type on haemostatic changes in women taking low dose oral contraceptives

Low‐dose combined oral contraceptives

Investigation of the Hemostatic Effect of a Transdermal Patch Containing 0.55 mg Ethinyl Estradiol and 2.1 mg Gestodene Compared with a Monophasic Oral Contraceptive Containing 0.03 mg Ethinyl Estradiol and 0.15 mg Levonorgestrel: An Open-Label, Randomized, Crossover Study

Contact Info

Product

Resources

About