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Thromb Haemost 2007; 98(06): 1246-1251
DOI: 10.1160/TH07-02-0139
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

APC resistance during the normal menstrual cycle

Marianne van Rooijen
1   Department of Woman and Child Health, Division of Obstetrics and Gynecology
,
Angela Silveira
2   Department of Medicine, Atherosclerosis Research Unit
,
Stella Thomassen
4   Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
,
Jacob Odeberg
2   Department of Medicine, Atherosclerosis Research Unit
3   Division of Hematology and Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden,
,
Anders Hamsten
2   Department of Medicine, Atherosclerosis Research Unit
,
Jan Rosing
4   Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
,
Katarina Bremme
1   Department of Woman and Child Health, Division of Obstetrics and Gynecology
› Author Affiliations Financial support: This study was supported by grants from Karolinska Institutet, the Swedish Medical Research Council, the Swedish Heart-Lung Foundation and the Karolinska University Hospital.
Further Information

Publication History

Received 23 February 2007

Accepted after resubmission 22 September 2007

Publication Date:
30 November 2017 (online)

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Summary

Increased serum levels of endogenous as well as exogenous estrogen are regarded to be responsible for acquired activated protein C (APC) resistance. It was the objective of this study to evaluate whether the physiological increase in serum estradiol concentration during the normal menstrual cycle affects the individual’s sensitivity to APC. Seventy-two women with normal menstrual cycles were included in the study. Blood samples for analysis of estradiol (E2), progesterone (P4) and APC resistance were drawn at two time points of the menstrual cycle (day 3–5 and day 22–25). Two methods of measuring APC resistance were used: the activated partial thromboplastin time (aPTT)-based assay and the endogenous thrombin potential (ETP)-based APC resistance test. Independent of the method used, no changes in APC resistance were found, even though the E2 concentration increased significantly between the two menstrual phases. No correlations between E2 levels and APC resistance, P4 levels and APC resistance or changes in E2 concentrations and changes in APC resistance were detected. Ten women were carriers of the factor VLeiden mutation. Their baseline APC resistance was increased, but their response to elevated E2 during the menstrual cycle did not differ from that of non-carriers. In conclusion, our observations suggest that physiological differences in serum levels of estradiol and progesterone between the early follicular and the luteal phase in a normal menstrual cycle do not have any significant impact on the individual’s sensitivity to APC.

Keywords

Menstrual cycle - APC resistance - ETP-based - aPTT-based - estradiol
 

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