Research
Hormonal
Oral conjugated estrogen therapy enhances systemic fibrinolysis, as evidenced by increased D-dimer levels, which correlates inversely with the reduction in PAI-1 levels.
When oral estrogen lowers PAI-1, it functionally increases the breakdown of blood clots (fibrinolysis), shown by higher D-dimer levels. This suggests oral estrogen may help prevent clot-related cardiovascular events by keeping the blood's clot-dissolving system active.
GoodSupportsHIGH confidence
The degree of reduction in PAI-1 levels was associated with increases in D-dimer levels both when conjugated estrogen was given alone (r=-0.572, P=0.001) and when combined hormone therapy was given (r=-0.541, P=0.002).
Why this rating
Same study as N1, randomized crossover design.
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
crossover · n=50Cited 376×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- 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.Good
- Transdermal estradiol (0.1 mg/day) does not significantly alter PAI-1 levels or enhance fibrinolysis in postmenopausal women, unlike oral estrogen.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →