Clinical relevance of hypercoagulability and possible hypofibrinolysis associated with estrone and estriol

Albe C. Swanepoel, Priyaa Naidoo, Vance G Nielsen, Etheresia Pretorius

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Estrone (E1) and Estriol (E3) are endogenous female hormones, present in increased concentrations during female specific physiological processes (menopause and pregnancy respectively) that are associated with increased venous thrombotic risk. These hormones are also used as hormone therapies that are also associated with increased thromboembolism risk. Viscoelastic analysis revealed no significant difference to clot formation after hormone addition, however morphological analysis showed that the addition of both E1 and E3 result in fibrin clots composed of thinner fibrin fibers arranged in dense matted networks. These changes to the fibrin network ultrastructure are indicative of a prothrombotic state but may also indicate hypofibrinolysis. We therefore conclude that the increased risk of venous thrombosis during pregnancy and menopause may originate from a combination of hypercoagulation and a possible hypofibrinolytic mechanism of these hormones. Therefore females with a hypercoagulable tendency that fall pregnant or enter menopause need to be monitored to prevent venous thrombotic events. The decision to use hormone therapies during and after menopause should not be taken lightly and the risk-reward scale should be closely examined to ensure it does not tip towards thrombosis and subsequent thrombotic events that ultimately could have been prevented.

Original languageEnglish (US)
JournalMicroscopy Research and Technique
DOIs
StateAccepted/In press - 2017

Fingerprint

Estriol
Thrombophilia
hormones
Estrone
Hormones
fibrin
Menopause
Fibrin
thrombosis
pregnancy
therapy
Physiological Phenomena
Pregnancy
Thromboembolism
Reward
Venous Thrombosis
tendencies
Thrombosis
fibers
Fibers

Keywords

  • Estriol
  • Estrone
  • Hypercoagulability
  • Menopausal hormone therapy
  • Venous thrombosis

ASJC Scopus subject areas

  • Anatomy
  • Histology
  • Instrumentation
  • Medical Laboratory Technology

Cite this

Clinical relevance of hypercoagulability and possible hypofibrinolysis associated with estrone and estriol. / Swanepoel, Albe C.; Naidoo, Priyaa; Nielsen, Vance G; Pretorius, Etheresia.

In: Microscopy Research and Technique, 2017.

Research output: Contribution to journalArticle

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