The influence of Evra transdermal contraceptive system on blood coagulation and fibrinolytic profile as well as the quality of sexual life


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


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.

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