Influence of contraceptive pill use, premenopause and postmenopausal state on hemostatic parameters in ethnic Chinese women

Background: Epidemiological studies has shown that increased fibrinogen and factor VIIc are two independent risk factors for cardiovascular disease (CVD). Postmenopausal women have a higher incidence of CVD than premenopausal women; one possible explanation is the increase of fibrinogen. Purpose: This study was undertaken to evaluate the influence of oral contraceptive pill use and postmenopausal status on coagulation factors in ethnic Chinese women. Patients and methods: This study included 1402 women aged 40-55 years, with 288 premenopausal women taking oral contraceptives and 364 postmenopausal women. All subjects underwent blood examination of prothrombin time, activated partial thromboplastin time, fibrinogen, factor VIIc, factor VIIIc, plasminogen, and antithrombin III. Results: Data show that oral contraceptives users had a significant increase in plasminogen (91.7 ± 40.7 vs. 80.0 ± 26.5%; p <0.01), while the levels of other hemostatic parameters were similar to non-contraceptive pill users. Postmenopausal women also had higher levels of plasminogen (113 ± 36.2 vs. 108.7 ± 30.7%; p = 0.06); the other parameters also show no statistical significance. Conclusions: Contrary to previous reports, which show elevation of fibrinogen and antithrombin III in menopause and in pill users, this study shows that only plasminogen levels exhibit a statistically significant contraceptive trend in Chinese women. Whether racial difference may account for the discrepancy in the present results needs further evaluation.