Comparison of a transdermal contraceptive patch vs. oral contraceptives on hemostasis variables

Contraception. 2008 Feb;77(2):77-83. doi: 10.1016/j.contraception.2007.10.004. Epub 2008 Jan 11.

Abstract

Purpose: The aim of this study was to compare effects of the transdermal contraceptive patch, a desogestrel/ethinyl estradiol (EE)-containing, monophasic combination oral contraceptive (COC) and a levonorgestrel/EE-containing, triphasic COC on hemostasis variables.

Study design: This was a randomized, open-label study of 104 young women who received six cycles of treatment. Blood was collected at baseline and on treatment; changes by Day 20/Cycle 6 in baseline hemostasis markers [prothrombin fragment 1+2 (F 1+2), plasmin-plasmin inhibitor complex (PAP) and fibrin degradation products (D-dimer)] were assessed.

Results: All contraceptives induced similar increases in F 1+2 and D-dimer. Patch-induced PAP increases were less than with the monophasic and similar to the triphasic COC. Decreases in protein S and increases in sex hormone-binding globulin were greater with the patch than with either COC. Patch-induced increases in activated protein C resistance were greater than with the triphasic and similar to the monophasic COC.

Conclusion: These contraceptives appeared to accelerate baseline procoagulation processes to a similar extent and to change coagulation potency variables differently.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Adolescent
  • Adult
  • Antifibrinolytic Agents / blood
  • Biomarkers / blood
  • Blood Coagulation / drug effects*
  • Blood Coagulation Factors / metabolism
  • Contraceptives, Oral, Combined
  • Desogestrel / administration & dosage*
  • Ethinyl Estradiol / administration & dosage*
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Fibrinolysin / metabolism
  • Homeostasis / drug effects*
  • Humans
  • Levonorgestrel / administration & dosage*
  • Middle Aged
  • Peptide Fragments / blood
  • Prospective Studies
  • Protein Precursors / blood
  • Prothrombin

Substances

  • Antifibrinolytic Agents
  • Biomarkers
  • Blood Coagulation Factors
  • Contraceptives, Oral, Combined
  • Fibrin Fibrinogen Degradation Products
  • Peptide Fragments
  • Protein Precursors
  • fibrin fragment D
  • Ethinyl Estradiol
  • Levonorgestrel
  • prothrombin fragment 1
  • prothrombin fragment 2
  • Desogestrel
  • Prothrombin
  • Fibrinolysin