Hormonal
Oral conjugated estrogen (0.625 mg/day) and combined oral estrogen/progestin (0.625 mg estrogen + 2.5 mg medroxyprogesterone acetate) significantly reduce plasma PAI-1 levels by approximately 50% in postmenopausal women, thereby enhancing systemic fibrinolysis.
For postmenopausal women, oral hormone replacement therapy (specifically conjugated estrogen) significantly lowers PAI-1, a protein that inhibits blood clot breakdown, by about half. This suggests oral estrogen may improve the body's ability to dissolve clots. However, transdermal (patch) estrogen does not appear to have this effect, and the net cardiovascular benefit is uncertain because oral estrogen might also increase other clotting risks in some women. This is not a standalone treatment for heart disease prevention without considering individual risk factors.
Conjugated estrogen, both alone and in combination with medroxyprogesterone acetate, reduced mean plasma levels of PAI-1 from 32 ng per milliliter to 14 ng per milliliter (P<0.001) and from 31 ng per milliliter to 15 ng per milliliter (P=0.003), respectively... Conjugated estrogen, alone or combined with progestin therapy, reduced PAI-1 levels by approximately 50 percent in postmenopausal women and was associated with enhanced systemic fibrinolysis.
Why this rating
Randomized, crossover, double-blind design with a small sample size (n=50).
Source
Effects of Hormone-Replacement Therapy on Fibrinolysis in Postmenopausal Women
Kwang Kon Koh et al. · New England Journal of Medicine · 1997
DOI 10.1056/nejm199703063361002
More from this paper
- Oral conjugated estrogen therapy enhances systemic fibrinolysis, as evidenced by increased D-dimer levels, which correlates inversely with the reduction in PAI-1 levels.Good
- Transdermal estradiol (0.1 mg/day) does not significantly alter PAI-1 levels or enhance fibrinolysis in postmenopausal women, unlike oral estrogen.Good
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