The influence of Evra transdermal contraceptive system on
blood coagulation and fibrinolytic profile as well as the quality of sexual life
Skrzypulec V, Drosdzol A, Nowosielski K
Woman’s Health Chair. The Medical University of Silesia in
Katowice, Poland
Deep vein thrombosis is a serious complication of oral
contraception. The most serious complication – pulmonary embolism, could be
lethal. The relative risk of thromboembolic disease is four time higher in women
using oral contraception. Both the amount of estrogen and the type of gestagen
can increase the relative risk of thromboembolic disease. Oral contraceptives
influence procoagulants, fibrinolytic system and inhibitors of coagulation.
Objectives: The aim of the study was to determine the
effect of Evra contraceptive patch (20 µg ethinyl estradiol and 150 µg of
norelgestromin) on the coagulation and fibrinolytic system in a group of normal
healthy women. Moreover, the influence of Evra system on sexual life quality was
evaluated.
Design and methods: 31 healthy female volunteers aged
between 19 and 35 years (26,8 +/- 2,5 years) with normal menstrual cycles were
included into a study. Control group included 30 healthy nonpregnant females in
the same age range who did not take any drug and were not suffering from any
disease. Blood sample was collected at a baseline level and after 6 months of
Evra use. The parameters examined were: prothrombin time, partial thromboplastin
time, fibrinogen level, platelet count and D-dimer level. The Female Sexual
Function Index was used to evaluate the quality of sexual life. Statistica 6,0
computer software with multiple regression model and ch2 test were used for
statistical analysis.
Results: An increase in mean prothrombin time after 6
months of Evra use in investigated group was statistically significant. There
was a decrease in mean partial thromboplastin time in investigated group
compared to control one (p>0,005). Mean plasma fibrinogen level increased
after the use of Evra patch (p<0.05). Mean platelet count showed significant increase in the investigated group. Therefore, an increase for the fibrinolytic parameter D-dimer was found. The results showed that some coagulation tests were significantly altered during transdermal contraceptive system use but these changes were not enough to manifest clinically as a thromboembolic phenomenon. In the aspect of sexual life, the research showed statistically significant intensification of sexual activity in the investigated group (99,6% sexually active) in comparison to control one.
Conclusions: Evra transdermal contraceptive system caused
an activation of the coagulation system which was balanced by an activation of
the fibrinolytic system. Evra transdermal contraceptive system improved the
quality of female sexual life.