Fibrinogen‐Fibrin Degradation Products in Menstrual Blood from Women with Normal and Excessive Menstrual Blood Losses

Abstract

Fibrinogen-fibrin degradation products, FDP, in menstrual blood during the first three days of menstrual blood during the first three days of menstruation have been investigated. Two groups of women were studied, those with normal menstrual blood loss (15 women, mean loss 30 ml, range 8-60 ml) and those with menorrhagia (14 women, mean loss 222 ml, range 107-729 ml). The following results were obtained: 1). The FDP concentrations decreased during menstruation in both groups. 2). The FDP concentrations in the two were compared for each day of the menstrual period. No differences were found between the two groups. A possible explanation of the results is given: there is a higher rate of coagulation and fibrinolysis in the endometrium of women with menorrhagia compared with women with normal blood losses. The hypothesis is supported by results of studies in which tranexamic is supported by results of studies in which tranexamic acid, an inhibitor of fibrinolysis, was given to reduce the menstrual blood loss. 3). The FDP excretion patterns differed from women to women. There were no consistent differences between the menorrhagic and the control group.

Prostaglandins in menstrual fluid in menorrhagia and dysmenorrhoea

“…However, work is being pursued concerning endometrial and myometrial tissue production in vitro of these two prostaglandins (Rees et al 1984). In addition, factors other than prostaglandins have to be considered since abnormalities in fibrinolytic activity have also been described in menorrhagia (Rybo 1966;Hahn & Rybo 1975) and heparin-like activity has been found in uterine fluid (Foley et al 1978). Therefore much basic research remains to be undertaken if we are to understand the mechanisms involved in the pathogenesis of menorrhagia and dysmenorrhoea.…”

Relation Between Measured Menstrual Blood Loss and Patient's Subjective Assessment of Loss, Duration of Bleeding, Number of Sanitary Towels Used, Uterine Weight and Endometrial Surface Area

“…Previous studies from this department (Haynes et al, 1979) have suggested that most women with regular but excessive menstrual blood loss (>80 ml per period) are ovulating and that serum levels throughout the menstrual cycle of gonadotrophins, oestradiol, and progesterone in women with menorrhagia are no different from those in women with normal menstrual blood loss. In the absence of any obvious abnormality of pituitary-ovarian function, the cause of this unexplained heavy menstruation could be due to an abnormality in function of the endometrium or myometrium or in their blood supply, and a defect in prostaglandin synthesis and/or metabolism (Downie et al, 1974;Smith, 1979) or in fibrinolytic activity (Rybo, 1966;Hahn and Rybo, 1975) could be postulated.…”

Consumption of fibrinolytic proteins in menstrual fluid from women with normal menstrual blood loss.

“…That normal menstrual blood appears to be fibrinolytically exhausted strongly suggests that other factors within the endometrium are responsible for the heavy menstrual blood loss that is ameanable to treatment with synthetic antifibrinolytic agents.4 20 The excellent technical assistance of Mrs F Daniels is acknowledged. This study was supported by grants from the British Heart Foundation (grant no 83/10), the Medical Research Council, and Parke-Davis Pharmaceuticals.…”