Background: Hormonal contraception (HC) is used by 9% of women worldwide. Although rare, thrombosis represents a serious side effect of HC. The risk of thrombosis is influenced by the estrogen component, dose, type, use duration, and family history. The risk increases two-folds (10–20/ 10,000) in women using HC compared to healthy, non-pregnant women, not using HC. Conventional haemostasis testing may not detect hypercoagulability or predict thrombosis risk.

Aims: To assess the coagulation profile in association with hormonal contraception in young female using thromboelastography (TEG) and evaluate the potential value of TEG in monitoring the possible risk of thrombosis and guiding individualized approach hormonal contraception.

Methods: 300 young females were recruited from two post-secondary institutions for this study. Data on age, type, duration and whether first or recurrent use, were collected. Citrated whole blood was drawn within the first 14 day of menstrual cycle. TEG was performed using a TEG® 5000 Hemostasis System. The following major parameters were evaluated: time to clot formation (R), rate of clot formation (K), speed of clot propagation (α), strength of clot (MA), Clot lysis after 30 min. (LY30) and clotting index (CI). Student t test was used to assess the difference in TEG parameters between HC users and non-users.

Results: 27 females (17 users and 10 non-users), aged 19- 29 were tested. The Average reported duration of use was 5 years. Comparative analysis of TEG parameters of the two age-matched groups showed no significant difference in any of the parameters. However, there is a trend towards hypercoagulability observed in α (p= 0.09) and the trend towards fibrinolysis observed in LY30 (0.09), in HC users compared to the non-users (Table 1).

Conclusion(s): Based on this small sample, there seems to be no change in coagulation profile with HC use. Additional assessments are needed before a final conclusion can be made.

Table

Comparative analysis of TEG parameters between female HC users and non users.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/thromboelastography-assessing-coagulation-profile-in-young-women-using-hormonal-contraception/