Endometrial fibrinolytic enzymes in women with normal menstruation and dysfunctional uterine bleeding

Abstract

Objective To study fibrinolysis in the endometrium in women with normal menstruation and dysfunctional uterine bleeding (DUB). Design Tissue plasminogen activator activity (t‐PA) and antigen (t‐PAAg) and plasminogen activator inhibitor Type 1 antigen (PAI‐1) were measured in homogenates of endometrium sampled between 24 and 36 h after the onset of menstruation. Subjects Women complaining of menorrhagia who had negative findings at clinical examination and curettage had their menstrual blood loss (MBL) measured from the third cycle after D&C. Those with MBL greater than 80 ml per cycle formed the DUB group. Measurements Fibrinolytic enzyme antigen levels were measured with ELISAs. Tissue plasminogen activator activity was assayed by measuring the rate of conversion of Glu‐plasminogen to plasmin, using a chromogenic plasmin substrate. Conclusions There is a strong positive correlation between endometrial t‐PA activity on the second day of menstruation and measured menstrual loss (P<0.05). Concentrations of endometrial t‐PAAg and PAI‐1 antigen are higher in women with DUB compared with normal women during menstruation.

Vascular development in endometriosis

“…This suggest that the plasminogen system is involved in endometrial angiogenesis. Women with dysfunctional bleeding were shown to have elevated levels of tPA activity and PAI-1 antigen during menstruation [60,61]. Therefore, endometrial tissue shed in women with heavier menstrual bleeding may produce larger amounts of PA and PAI-1, which upon adhesion may induce a larger angiogenic response.…”

Effect of Polyherbal Drug on Menorrhagia and Its Evaluation by Assesing Biomarker Serum VEGF-A

“…This is important in the context of the endometrium, as coagulation (Gleeson, et al, 1993) here differs from that in other regions of the body, in that, rapid coagulation and fibrinolysis of the blood occurs as it passes down the spiral arterioles. This is presently thought to be an important part of the mechanism of excessive menstrual bleeding.…”

Near‐fatal uterine hemorrhage during induction chemotherapy for acute myeloid leukemia: A case report of bilateral uterine artery embolization

“…Antifibrinolytics have been utilized successfully to treat both dysfunctional uterine bleeding in nonleukemic patients and mucosal bleeding in leukemic patients [13,14]. Its efficacy in the setting of dysfunctional uterine bleeding is attributed to inhibition of abnormally elevated intrauterine fibrinolytic activity [15]. rVIIa has been reported to control refractory uterine bleeding in at least one case of refractory thrombocytopenia in the bone marrow transplant setting [16].…”