Do Sexual Hormones Influence the Coagulation Parameters during the Normal Menstrual Cycle

Introduction:

The blood coagulation can be influenced by different variables like mental stress, physical activity or oral anticoagulants. During the normal menstrual cycle changes have been observed on different time points. A study of Chaireti et al (1) found an association of progesterone and factor II, factor VII and factor X.

We investigated the possible influence of the sexual hormones on the coagulation parameters.

Samples and methods:

We conducted a laboratory work group in 35 women sent to our lab. The following tests were conducted: Blood count, VWF:RCo, VWF:Ag, VWF:CB, Fibrinogen (Clauss), activities of FII, FV, FVII, FVIII (clotting and chromogenic), FIX, FX, FXI, FXII, FXIII, FSH, LH, Progesterone and Oestradiole during the menstrual cycle on predefined time points (day 1-6, day 7-11, day 12-18, day 19-23, day 24-28).

Results:

We found slight variations in nearly all coagulation parameters but without significance. The box-plots of the Von Willebrand activity shows that the means are relative close together. Clear variations could not be found. The Friedman-Test showed no significance. As expected the changes of the sexual hormones during the menstrual cycle showed highest significance.

Conclusion:

The influence of sexual hormones on coagulation parameters was not significant. The slight fluctuations may be caused by imprecision of the measurement and intra individual changes from day to day. Changes during the menstrual cycle could not be verified.

Nevertheless it is advisable to investigate unclear negative results, when a conspicuous medical history or a corresponding clinic occurs. It is not necessary to regard the time point in the menstrual cycle for the blood collection.

Literature:

1. Chaireti R, Gustafsson KM, Byström B, Bremme K, Lindahl TL, Endogenous thromboin potential is higher during the luteal phase than during the follicular phase of a normal menstrual cycle, Hum Repro, 2013 Jul, 28 (7) 1846-52