• S C Koh, S S Ratnam, and F H Tsakok.
• Department of Obstetrics & Gynaecology, National University of Singapore, National University Hospital.
• Singap Med J. 1990 Apr 1; 31 (2): 116-22.

AbstractA longitudinal controlled study on the effect of Diane and Microgynon 50 (Micro 50) contraceptive pills on the haemostatic mechanisms in 59 Chinese subjects was carried out. Diane, containing the potent anti-androgen progestagen, cyproterone acetate was used as a contraceptive and in subjects requiring anti-androgenic treatment and fertility control. Enhanced fibrinolytic activity with raised plasminogen and alpha 1-antitrypsin (a1-AT) was observed in all subjects after pill treatment. The changes observed after Diane treatment suggests a predispostion to hypercoagulation as evidenced by increases in Fibrinogen, Factors VII and X with accelerated Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) and Reaction and Clotting Time (r + k). Maximum elasticity of the clot was raised after Diane 50 treatment when compared with pre-treatment levels. More changes in haemostasis were seen after treatment with Diane containing 35 ug and 50 ug ethinyl estradiol (EE) formulation than during Micro 50 treatment. The results from this study show that Diane even with 35 ug EE formulation caused coagulation changes which were more pronounced than the 50 ug EE Microgynon. The finding is at variance with others that ascribe haemostatic changes observed to increased oestrogen content in a given pill formulation and so merits confirmation in a larger study.

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