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Synthetic Hormones and Clot Formation

Published online by Cambridge University Press:  12 August 2016

Albe C. Swanepoel ,
Amcois Visagie  and
Etheresia Pretorius
Albe C. Swanepoel*
Affiliation:
Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Pretoria, Arcadia0007, South Africa
Amcois Visagie
Affiliation:
Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Pretoria, Arcadia0007, South Africa
Etheresia Pretorius*
Affiliation:
Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag x323, Pretoria, Arcadia0007, South Africa
*
*Corresponding authors. albe.swanepoel@up.ac.za; resia.pretorius@up.ac.za
*Corresponding authors. albe.swanepoel@up.ac.za; resia.pretorius@up.ac.za
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Abstract

Combined oral contraceptives (COCs), colloquially referred to as “the pill,” have been regarded as a medical breakthrough, as they have improved the lives of countless women, from simplifying family planning to the treatment of acne, endometriosis, polycystic ovarian syndrome, and dysmenorrhea. Unfortunately, COC usage has been associated with an increased occurrence of venous thrombosis and therefore a systemic hypercoagulable state in susceptible females. Here we discuss the health risks of COC usage and use viscoelastic and morphological techniques to investigate the effect of different COC constituents on clot formation, particularly fibrin network packaging and whole blood viscoelasticity. Viscoelastic properties of whole blood showed gender-specific changes while morphological alterations were person-specific, regardless of gender. Using scanning electron microscopy and thromboelastography provides great insight regarding fibrin packaging and the development of a hypercoagulable state in high-risk individuals. We proposed a three-step approach where (1) an individual’s coagulation profile baseline is determined, after which (2) the “ideal” combination of constituents is prescribed, and (3) the coagulation profile of the individual is monitored to assess possible risk of thrombosis. Only in following such an individualized patient-oriented approach will we be able to avoid the many health issues due to COC usage in susceptible females.

Keywords

combined oral contraceptiveshypercoagulabilityvenous thrombosismorphologyviscoelasticity
Type
Biological Applications
Information
Microscopy and Microanalysis , Volume 22 , Issue 4 , August 2016 , pp. 878 - 886
Copyright
© Microscopy Society of America 2016 

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