Alterations in Haematological and Clotting Profile of Post-Menopausal Women in Benin City, Nigeria

  • MI Ebengho
  • PA Obazelu
  • MA Emokpae
Keywords: Coagulation, Female, Menopause, Nigeria, Oestradiol, Plasma viscosity, Post-mennopause

Abstract

Background: The cessation of ovarian functions at menopause and the accompanying decline in the production of ovarian steroid hormones creates a unique set of health concerns for women. Reductions in sex steroid levels, particularly oestrogen, have been associated with various diseases and conditions, including bleeding disorders, coronary heart disease (CHD), osteoporosis, cognitive dysfunction, urinary incontinence, hot flushes, and mood changes, among others.

Objective: To determine changes in haemorheological and clotting profile in post-menopausal women.

Methods: Two hundred participants comprising one hundred and fifty post-menopausal women and fifty healthy pre-menopausal control subjects were studied. The investigations carried out include whole blood viscosity, plasma viscosity, fibrinogen concentration, Prothrombin time (PT), Activated partial thromboplastin time with kaolin (APTTK) levels and complete blood count using standard methods.

Results: The mean age (p = 0.01), platelet count (p = 0.013), neutrophil (p = 0.03), neutrophil to lymphocyte ratio (p = 0.045) and platelet to lymphocyte ratio (p = 0.044) in postmenopausal women were significantly higher while lymphocyte count (p = 0.004) was significantly lower in postmenopausal compared to premenopausal women. Similarly, plasma oestradiol (p = 0.001), plasma viscosity (p = 0.03), relative blood viscosity (p = 0.03), whole blood viscosity (p = 0.03) and PTTK (p = 0.04) were significantly lower among postmenopausal women compared to premenopausal control subjects.

Conclusion: Relative plasma viscosity correlated positively with age. There were significantly lower levels of haemorheological and clotting profile in post-menopausal women. These changes may be due to age or a decline in circulating oestrogen levels.

Author Biography

MA Emokpae

Department of Medical Laboratory Science and Associate Professor

References

Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, et al. Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive ageing. Fertil Steril 2012; 97: 398–406. https://doi.org/10.1097/gme.0b013e31824d8f40

Thomas HN, Neal-Perry GS, Hess R. Female sexual function at midlife and beyond. Obstet Gynecol Clin North Am 2018; 45: 709-722. https://doi.org/10.1016/j.ogc.2018.07.013

Falkeborn M, Schairer C, Naessen T, Persson I. Risk of myocardial infarction after oophorectomy and hysterectomy. J Clin Epidemiol 2000; 53: 832-837. https://doi.org/10.1016/s0895-4356(00)00187-6

Lobo RA. Hormone Replacement therapy- Current thinking. Nat Rev Endocrinol 2017; 13: 220-231. https://doi.org/10.1038/nrendo.2016.164

McCarrey AC, Resnick SM. Post-menopausal hormone therapy and cognition. Horm Behav 2015; 74: 167-172. https://doi.org/10.1016/j.yhbeh.2015.04.018

Conway F. Health-related issues impacting older adults. J Women Aging 2019;31: 93-94.

Nkonde-Price C, Bender JR. Menopause and the Heart. Endocrinol Metab Clin North Am 2015; 44: 559-564.

Tarumi W, Shinohara K. The Effects of Essential oil on salivary oxytocin concentration in post-menopausal women. J Altern Complement Med 2020; 26: 226-230. https://doi.org/10.1089/acm.2019.0361

Nogueira IAL, da Cruz ÉJSN, Fontenele AMM, Figueiredo Neto JA1. Alterations in postmenopausal plasmatic lipidome. PLoS One 2018; 13: e0203027.

Hashemzadeh M, Romo R, Arreguin JM, Movahed MR. The effects of estrogen and hormone replacement therapy on cardiovascular systems. Future Cardiol 2021; 17: 347-353. https://doi.org/10.2217/fca-2020-0054

Gersh FL, O'Keefe JH, Lavie CJ. Post-menopausal hormone therapy for cardiovascular health: the evolving data. Heart 2021; 107: 1115-1122. https://doi.org/10.1136/heartjnl-2019-316323

US Preventive Services Task Force (USPSTF). Screening for osteoporosis in post-menopausal women: recommendations and rationale. Ann Intern Med 2002; 137: 526-528.

National Library of Medicine (NLM). Health consequences of tobacco use among women. In: AHCPR Archived Reports, Put Prevention into Practice and Minnesota Health Technology Advisory Committee. Reports of the Surgeon General. Women and Smoking. 2008. https://www.ncbi.nlm.nih.gov/books/NBK44312/ Accessed on 20 December 2021.

Elblbesy MA. Plasma viscosity and whole blood viscosity as diagnostic tools of blood abnormalities by using simple syringe method. Am J Haematol 2014; 2: 1-5. http://dx.doi.org/10.7243/2052-6962-2-5

Clauss A. Rapid Physiological Coagulation Method in Determination of Fibrinogen. Acta Haematologica 1957; 17: 237-246.

Kulkarni M and Hiremath S. Hematological changes in post-menopausal women. Natl J Physiol Pharm Pharmacol 2019; 9: 248-250. https://doi.org/10.5455/njppp.2019.9.0101515012019

Henes M, Hubner S. Hormone replacement therapy in peri- and postmenopause Internist (Berl) 2020; 61: 558-564. https://doi.org/10.1007/s00108-020-00789-x

Nakada D, Oguro H, Levi B, Ryan N, Kitano A, Saitoh Y, et al. Estrogen increases haematopoietic stem-cell self-renewal in females and during pregnancy. Nature 2014; 505: 555–558. https://doi.org/10.1038/nature12932.

Grays S. Tales from the Clinic. Post Reprod Health 2020; 26: 46-48. https://doi.org/10.1177/2053369120911552

Cowman J, Dunne E, Kenny D. Age-related changes in platelet function are more profound in women than in men. Sci Rep 2015; 5: 12235S. https://doi.org/10.1038/srep12235

Bain BJ, Bates I, Laffan MA, Lewis SM. Dacie and Lewis Practical Haematology. 11th Edition. Elsevier Churchill Livingstone. New York. USA. 2012. p. 653.

Schneider HPG, Birkhauser M. Quality of Life in Climacteric women. Climacteric 2017; 20: 187-194. https://doi.org/10.1080/13697137.2017.1279599

Kofoed SC, Wittrup HH, Sillesen H, Nodestgaard BG. Fibrinogen predicts ischemic stroke and advanced atherosclerosis but not rupture-prone carotid plagues. Copnhangen City Euro-Heart J 2018; 24: 567-576.

Butkiewicz AM, Kemona H, Dymicka-Piekarska V, Matowicka-Karna J. Does menopause affect thrombocytopoiesis and platelet activation? Przegląd Lekarski 2006; 63: 1291-1293.

Lowe G, Rumley A, Norrie J, Ford I, Shepherd J, Cobbe S, et al. Blood rheology, cardiovascular risk factors and cardiovascular disease: the West of Scotland Coronary Prevention Study. J Thromb Haemost 2000; 84: 553–558.

Published
2022-03-25
Section
Original Research