Parameters of Fibrinolysis in Postmenopausal Women Taking Oral and Transdermal Hormone Replacement Therapy

Background. Postmenopausal women constitute approximately 30% of the world’s population. More than a third of the life of contemporary women falls within the period after menopause. Women with considerable sex hormone deficiency should take an exogenous hormone replacement. Objectives. The aim of the study was to assess selected parameters of fibrinolysis such as tissue plasminogen activator antigen (t-PA Ag), plasminogen activator inhibitor type 1 antigen (PAI-1 Ag), D-dimers, fibrinogen, and antiplasmin (AP) activity in postmenopausal women who were taking oral or transdermal hormone replacement therapy (HRT). Material and Methods. The study was conducted on 76 healthy nonsmoking postmenopausal women. Forty-six women aged 44–58 years were taking oral (26) or transdermal (20) HRT. The control group consisted of 30 women aged 44–54 years who did not take HRT. The concentrations of t-PA Ag, PAI-1 Ag, D-dimers, and fibrinogen and the activity of AP were determined in plasma. Results. Women using transdermal HRT had significantly higher concentrations of t-PA Ag and PAI-1 Ag than those taking oral HRT (p < 0.03 and p < 0.0001, respectively) and those of the control group (p < 0.03 and p < 0.02, respectively). AP activity among the women taking oral or transdermal HRT was significantly lower (p < 0.03 and p < 0.05, respectively) than in the control group. A lower concentration of fibrinogen was found in the women taking oral HRT than in the control group (p < 0.05). The average concentrations of D-dimer were similar in all the subjects. Conclusions. The increased t-PA Ag concentration and decreased antiplasmin activity among the women taking transdermal HRT can indirectly indicate an increased formation of plasmin. The increased PAI-1 Ag concentration in women taking transdermal HRT showed that PAI-1 participated in suppressing increased plasminogenesis. Transdermal HRT is undoubtedly more physiological, but it seems to be less effective if one considers the beneficial influence on hemostasis, although larger trials to confirm these results are needed (Adv Clin Exp Med 2010, 19, 2, 203–210).