ROME (ITALPRESS) – The relationship between hormones and coagulation is complex and, particularly in women, varies according to life stage. The contraceptive pill can interfere, accentuating the blood’s natural tendency to clot and increasing the risk of blood clots in arteries and veins, so-called ‘thrombi’ that can cause serious events. Pregnancy is by far the period when the risk of thrombus formation is highest, with different intensity in each woman, all the more so in the case of pregnancy supported by hormone therapies. Menopause is a delicate phase in which symptoms often occur that have a major impact on quality of life: before menopause, women are less affected by heart attack than men, while after, the incidence is similar. This observation led research to hypothesize that prolonging fertile life by hormone replacement therapy could reduce the likelihood of heart attacks in women, in addition to reducing menopausal symptoms. Coagulation is that extraordinarily sophisticated and very important mechanism that allows blood to flow fast and fluidly within our entire hydraulic system,” while thrombosis “means that a blood clot forms at a point or time when it was not supposed to form: it’s an overzealousness” that “can lead to very important events such as myocardial infarction, cerebral ischemia, and pulmonary embolism,” said Professor Lidia Rota, a hematologist specializing in hematology and cardiovascular disease from thrombosis, who founded the Association for the Fight Against Thrombosis and Cardiovascular Disease (ALT) in 1987, interviewed by Marco Klinger, for Medicina Top, a TV format of the Italpress news agency. Between hormones and coagulation there is a “dangerous relationship. Let’s start from the age of adolescence, when a girl might have a polycystic or multifollicular ovary, with an irregular menstrual cycle”: the gynecologist can prescribe “a contraceptive pill, which are hormones: you have to keep in mind that they will interfere a little bit with the coagulation system” and “you have to choose a product that is suitable so as not to harm her” based on her lifestyle habits and family history. Pregnancy is “by far the most delicate situation” in this respect: the woman “starts to have thicker blood, but that does not mean that all women will necessarily have a complication. A good gynecologist, for example, can warn the patient that the easiest remedy is to wear elastic stockings, which prevent the blood from slowing its course.” Childbirth is “the most delicate moment, whether by cesarean section or natural: inside her heart the woman pumps 5 liters of blood, at the end it is 7 and a half, but the heart is still the same.” Another delicate time in a woman’s life is menopause. “Hormone therapy can be important in women who have such strong symptoms that make life impossible: giving them hormones that mimic the prolongation of childbearing age might be a good temporary temporary remedy. My suggestion is that the gynecologist always assess what the risk-benefit of the therapy is,” as well as encouraging the woman to do “more physical activity to the extent possible.” The work of hematologists “is to be useful to all other specialists,” prepare “a personalized plan based on the history and characteristics” of the patient, to make sure that “she does not bleed, but neither does she thrombolize,” and for example at the time of surgery. In addition to collaboration between doctors, the patient is important. “In Italy,” he concluded, “there are 600,000 cases a year of diseases such as heart attack, ischemia, and pulmonary embolism, but a third of these might not happen if the patient is adequately and easily informed to control risk factors that he or she can eliminate on his or her own.
– photo taken from Top Medicine video -(ITALPRESS).
