Hemostasis and female sex hormones


  • О. А. Ефименко SI “Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”, Ukraine https://orcid.org/0000-0003-1228-0911
  • И. А. Родионова Institute of Postgraduate Education of Bogomolets National Medical University, Ukraine




estrogens, progesterone, venous thromboembolism, arterial thrombosis, hormonal contraception, menopausal hormone therapy, thrombophilia


The review considers modern concepts of the pathogenesis of coagulation disorders in women and the participation of endogenous and exogenous sex steroids in it. The analysis of the results of studies in recent years demonstrates significant contradictions on the influence of endogenous female sex steroids on the development of thrombotic events. In the context of thromboembolic complications association with the use of modern hormone containing medications, in particular combined hormonal contraceptives, genetically determined thrombophilia appears to be essential, but the possibility of their routine diagnostics to reduce risks is still not fully defined.

To date, recent clinical studies support the early use of menopausal hormone therapy (MHT) to slow the rate of atherosclerosis development and primary prevention of cardiovascular disease in women in early menopause. At the same time, researchers put forward a temporary theory of the use of MHT (the early beginning of the use of MHT from the onset of menopause provides the best protective effect of hormones on the vascular wall) as a way of successful prevention of cardiovascular diseases.

Correctly chosen tactics of preventive measures for a specific gynecologic patient can significantly reduce the risk of thromboembolic complications, prevent the development of disseminated intravascular coagulation syndrome or at least reduce its severity, shorten treatment time, and reduce morbidity and mortality caused by this pathology. Strict individual approach and targeted prevention, if it is carried out in all medical institutions and at all stages of management of pregnant and gynecological patients, can significantly reduce the frequency of these formidable complications.

Author Biographies

О. А. Ефименко, SI “Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”

PhD, senior researcher at the Endocrine Gynecology Department

И. А. Родионова, Institute of Postgraduate Education of Bogomolets National Medical University

PhD, associate professor at the Department of Infectious Diseases Therapy and Dermatovenereology


  1. Colman, R.W., ed. Hemostasis and thrombosis: basic principles and clinical practice. Lippincott Williams & Wilkins (2006).
  2. Kitchen, S., Olson, J.D., Preston, F.E., eds. Quality in laboratory hemostasis and thrombosis. John Wiley & Sons (2013).
  3. Key, N.S. Practical hemostasis and thrombosis. John Wiley & Sons (2017).
  4. Rumbaut, R.E., Thiagarajan, P. “Platelet-vessel wall interactions in hemostasis and thrombosis.” Synthesis Lectures on Integrated Systems Physiology: From Molecule to Function 2.1 (2010): 1–75.
  5. Cajozzo, A., et al., eds. Advances in Hemostasis and Thrombosis. Vol. 20. Springer Science & Business Media (2013).
  6. Cohen, H., O’Brien, P. “Disorders of Thrombosis and Hemostasis in pregnancy.” A guide to management 115 (2012): 219.
  7. Speroff, L., Fritz, M.A., eds. Clinical gynecologic endocrinology and infertility. Lippincott Williams & Wilkins (2005).
  8. Hvas, A.-M., Favaloro, E.J. “Gender related issues in thrombosis and hemostasis.” Expert review of hematology 10.11 (2017): 941–9.
  9. Keohane, E.M., Smith, L.J., Walenga, J.M. Rodak’s hematology: clinical principles and applications. Elsevier Health Sciences (2015).
  10. Van Winckel, M., et al. “Vitamin K, an update for the paediatrician.” European journal of pediatrics 168.2 (2009): 127.
  11. Pabinger, I., Schneider, B. “Thrombotic risk in hereditary antithrombin III, protein C, or protein S deficiency: a cooperative, retrospective study.” Arteriosclerosis, thrombosis, and vascular biology 16.6 (1996): 742–8.
  12. Potdar, N., et al. “Adjunct low-molecular-weight heparin to improve live birth rate after recurrent implantation failure: a systematic review and meta-analysis.” Human reproduction update 19.6 (2013): 674–84.
  13. Mahmoodi, B.K., et al. “Association of traditional cardiovascular risk factors with venous thromboembolism: an individual participant data meta-analysis of prospective studies.” Circulation 135.1 (2017): 7–16.
  14. Pfeifer, S., et al. “Combined hormonal contraception and the risk of venous thromboembolism: a guideline.” Fertility and sterility 107.1 (2017): 43–51.
  15. Baber, R.J., Panay, N., et al. “2016 IMS Recommendations on women’s midlife health and menopause hormone therapy.” Climacteric 19.2 (2016): 109–50.
  16. Kinsella, K.G., Phillips, D.R. Global aging: The challenge of success. Vol. 60. No. 1. Washington, DC: Population Reference Bureau (2005).
  17. Hodis, H.N., et al. “Vascular effects of early versus late postmenopausal treatment with estradiol.” New England Journal of Medicine 374.13 (2016): 1221–31.
  18. Raz, L., et al. “Differential effects of hormone therapy on serotonin, vascular function and mood in the KEEPS.” Climacteric 19.1 (2016): 49–59.
  19. Vavrinkova, B., et al. “Does asymptomatic carriage of FV Leiden and FII prothrombin mutations in heterozygous configuration pose an increased risk of thrombembolic complications in the course of pregnancy, labor and puerperium?” Biomedical Papers 158.2 (2014): 238–41.



How to Cite

Ефименко, О. А., & Родионова, И. А. (2018). Hemostasis and female sex hormones. REPRODUCTIVE ENDOCRINOLOGY, (39), 21–26. https://doi.org/10.18370/2309-4117.2018.39.21-26