European Journal of Clinical Pharmacology

, Volume 13, Issue 4, pp 251–257 | Cite as

Effect of the menstrual cycle, oral contraception and pregnancy on forearm blood flow, venous distensibility and clotting factors

  • R. Fawer
  • A. Dettling
  • D. Weihs
  • H. Welti
  • J. L. Schelling


Forearm blood flow, venous distensibility and various clotting factors were determined in 118 apparently healthy women (mean age 26 years), either during the menstrual cycle, or while taking a combined contraceptive (A) with high progestin: estrogen ratio (d-norgestrel 0.125 mg + ethinylestradiol 0.03 mg), or a sequential contraceptive (B) with low progestin:estrogen ratio (megestrol 0.1/1 mg + ethinylestradiol 0.1 mg), or in the 1st, 2nd and 3rd trimester of pregnancy. Venous distensibility in women taking contraceptive A was higher than in other women during the follicular phase of a normal menstrual cycle. Venous distensibility was not affected by contraceptive B. Blood flow and blood pressure remained unchanged by contraceptives A and B. Fibrinogen concentration was increased by both contraceptives, factor VII was either decreased (A) or unchanged (B), and factor X was either unchanged (A) or increased (B). The oral contraceptive with the high progestagen component appeared to increase venous capacitance and may induce venous stasis, whereas coagulability was particularly enhanced by the estrogen-type contraceptive. Pregnant women differed from women on oral contraceptives in regard to peripheral circulation; they showed a tremendous increase of blood flow with secondary vasodilation.

Key words

Venous circulation coagulation oral contraceptives pregnancy d-norgestrel megestrol ethinylestradiol 


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  1. 1.
    Astedt B., Isacson S., Nilsson I.M., Pandolfi M.: Thrombosis and Oral Contraceptives: Possible Predisposition. Br. med. J.1973/4, 631–634Google Scholar
  2. 2.
    Beral V.: Cardiovascular-disease mortality trends and oral-contraceptive use in young women. Lancet1976/II, 1047–1052Google Scholar
  3. 3.
    Böttiger L.E., Westerholm B.: Oral Contraceptives and Thromboembolic disease. Acta med. scand.190, 455–463 (1971)Google Scholar
  4. 4.
    Brown E., Greenfield D.M., Goei J.S., Plassaras G.: Filling and emptying of the low-pressure blood vessels of the human forearm. J. appl. Physiol.21, 573–582 (1966)Google Scholar
  5. 5.
    Collaborative Group for the Study of Stroke in Young Women: Oral contraception and increased risk of cerebral ischaemia or thrombosis. New Engl. J. Med.288, 871–878 (1973)Google Scholar
  6. 6.
    Drill V.A.: Oral Contraceptives and Thromboembolic Disease. I. Prospective and Retrospective Studies. J. Amer. Med. Ass.219, 583–592 (1972)Google Scholar
  7. 7.
    Dugdale M., Masi A.T.: Hormonal contraception and thromboembolic disease. Effects of oral contraceptives on hemostatic mechanisms. J. chron. Dis.23, 775–790 (1971)Google Scholar
  8. 8.
    Goodrich S.M., Wood J.E.: Peripheral venous distensibility and velocity of venous blood flow during pregnancy or during contraceptive therapy. Am. J. Obstet. Gynecol.90, 740–744 (1964)Google Scholar
  9. 9.
    Goodrich S.M., Wood J.E.: The effect of estradiol-17 on peripheral venous distensibility and velocity of venous flow. Am. J. Obstet. Gynecol.96, 407–412 (1966)Google Scholar
  10. 10.
    Grant E.C.G.: Venous Effects of Oral Contraceptives. Br. med. J.1969/4, 73–77Google Scholar
  11. 11.
    Inman W.H.W., Vessey M.P.: Investigation of Deaths from Pulmonary, Coronary and Cerebral Thrombosis and Embolism in Women of Child-bearing Age. Br. med. J.1968/2, 193–199Google Scholar
  12. 12.
    Inman W.H.W., Vessey M.P., Westerholm B., Engelund A.: Thromboembolic disease and the Steroidal Content of Oral Contraceptives. A Report to the Committee on Safety of Drugs. Br. med. J.1970/2, 203–209Google Scholar
  13. 13.
    Irey N.S., Manion W.C., Taylor H.B.: Vascular lesions in women taking oral contraceptives. Arch. Path.89, 1–8 (1970)Google Scholar
  14. 14.
    Jayle M.F.: Analyse des stéroïdes hormonaux. Tome II, p. 397. Paris: Masson 1962Google Scholar
  15. 15.
    Klopper A.I., Michie E.A., Brown J.B.: A method for the determination of urinary pregnanediol. J. Endocrinol.12, 209–219 (1955)Google Scholar
  16. 16.
    Mann J.I., Inman W.H.W.: Oral Contraceptives and Death from Myocardial Infarction. Br. med. J.1975/2, 245–248Google Scholar
  17. 17.
    Metcalfe J., Ueland K.: Maternal Cardiovascular Adjustements to Pregnancy. Progr. Cardiovasc. Dis.16, 363–374 (1974)Google Scholar
  18. 18.
    Neistadt A., Schwartz R.W., Schwartz S.I.: Norethinodrel with Mestranol and Venous Blood Flow. J. Amer. med. Ass.198, 784–785 (1966)Google Scholar
  19. 19.
    Poller L., Thomson J.M., Thomas W.: Oestrogen/Progestagen Oral Contraception and Blood Clotting: A Long-term Follow-up. Br. med. J.1971/4, 648–650Google Scholar
  20. 20.
    Poller L., Thomson J.M., Thomas P.W.: Effect of Progestagens Oral Contraception with Norethisterone on Blood Clotting and Platelets. Br. med. J.1972/3, 391–393Google Scholar
  21. 21.
    Ramcharan S., Pellerin F.A., Hoag E.: The occurrence and course of hypertensive disease in users and nonusers of oral contraceptive drugs. In: Fregly M.J. and Fregly M.S., ed. Oral Contraceptives and high blood pressure pp. 1–16. Gainesville, Florida: Dolphin Press 1974Google Scholar
  22. 22.
    Report from the Boston Collaborative Drug Surveillance Programme. Oral contraceptives and venous thromboembolic disease, surgically confirmed gallbladder disease and breast cancer. Lancet1973/I, 1399–1404Google Scholar
  23. 23.
    Rössener S., Larsson-Cohn U., Carlson L.A., Boberg J.: Effect of an oral contraceptive agent on plasma lipids, plasma lipoproteins, the intravenous fat tolerance and the post-heparin lipoprotein lipase activity. Acta med. scand.190, 301–305 (1971)Google Scholar
  24. 24.
    Royal College of General Practitioners. Oral contraceptives and health; an interim report from the oral contraception study of the Royal College of General Practitioners, p. 100. New York: Pitman, 1974Google Scholar
  25. 25.
    Royal College of General Practitioners' Oral Contraception Study. Mortality Among Oral-Contraceptive Users. Lancet1977/II, 727–731Google Scholar
  26. 26.
    Sartwell P.E., Masi A.T., Arthes F.G., Greene G.R., Smith H.E.: Thromboembolism and oral contraceptives: an epidemiologic case-control study. Amer. J. epidemiol.90, 365–380 (1969)Google Scholar
  27. 27.
    Schenker J.G., Oliver M.: The Effect of Oral Contraceptives on Microcirculation. Obstet. Gynecol.39, 909–916 (1972)Google Scholar
  28. 28.
    Seaton A.: Pulmonary capillary blood volume in women: normal values and the effect of oral contraceptives. Thorax27, 75–79 (1972)Google Scholar
  29. 29.
    Vessey M.P., Doll R.: Investigation of Relation Between Use of Oral Contraceptives and Thromboembolic Disease. Br. med. J.1968/2, 199–205Google Scholar
  30. 30.
    Vessey M.P., Doll R.: Investigation of Relation between Use of Oral Contraceptives and Thromboembolic Disease. A Further Report. Br. med. J.1969/2, 651–657Google Scholar
  31. 31.
    Vessey M.P., McPherson K., Johnson B.: Mortality among women participating in the Oxford/Family Planning Association Contraception Study. Lancet1977/II, 731–733Google Scholar
  32. 32.
    Walters W.A.W., Lim Y.L.: Cardiovascular dynamics in women receiving oral contraceptive therapy. Lancet1969/II, 879–881Google Scholar
  33. 33.
    Weir R.J., Briggs E., Mack A., Naismith L., Taylor L., Wilson E.: Blood Pressure in Women Taking Oral Contraceptives. Br. med. J.1974/1, 533Google Scholar
  34. 34.
    Wood J.E., Eckstein J.W.: A tandem forearm plethysmograph for study of acute responses of the peripheral veins of man. J. clin. Invest.37, 41–50 (1958)Google Scholar

Copyright information

© Springer-Verlag 1978

Authors and Affiliations

  • R. Fawer
    • 1
  • A. Dettling
    • 1
  • D. Weihs
    • 1
  • H. Welti
    • 1
  • J. L. Schelling
    • 1
  1. 1.Division of Clinical Pharmacology of the Department of Medicine, and Department of Gynecology and ObstetricsCentre Hospitalier Universitaire VaudoisLausanneSwitzerland

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