Early response of selected haemostatic and haematological parameters to physical activity in young women – the potential impact of oral contraceptives
More details
Hide details
Department of Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland
Department of Physiotherapy and Biological Rejuvenation, Pomeranian Medical University, Szczecin, Poland
Department of Cardiology, Pomeranian Medical University, Szczecin, Poland
Corresponding author
Maria Jastrzębska   

Department of Laboratory Diagnostics, Pomeranian Medical University, Szczecin, Poland
J Pre Clin Clin Res. 2017;11(1):15-21
Introduction and objective:
Exercise (submaximal) in untrained subjects can modify haemostasis toward hypercoagulability, especially among women using oral contraceptives (OC). The aim of this study was to investigate whether this can be explained by platelet haemostasis and changes in the generation of membrane microparticles.

Material and Methods:
Young, healthy women (n=60) were divided into 2 equal groups: a study group OC (+) who had used OC for >3 months, and controls who had never used oral contraceptives OC(-). Exclusion criteria: those with systematic daily physical activity. Participants were subjected to treadmill exercise (Cardiac Diagnostic System; model CH2000) using the Bruce protocol/ AHA guidelines. Platelet aggregation with arachidonic acid (ASPI test) or ADP (ADP test), membrane microparticle (MP) activity, plasma coagulation times (APTT/PT) and blood count were determined before and 45 minutes after exercise.

Before exercise, the OC(+) group had slightly higher platelet aggregation (ADP test), significantly lower MP activity, slightly lower PLT and slightly higher PDW rate. Exercise caused slight inhibition of platelet aggregation (ASPI test), and significant decrease in MP activity – only in the OC(-) group. After exercise, in both groups there was a significant decrease in PLT and increase in WBC, more pronounced in OC(+) group.

Submaximal exercise was beneficial for haemostasis in women not using hormonal contraception, associated primarily with reduced MP activity. No beneficial effects of physical activity were found for women using hormonal contraceptives, possibly associated with a hypercoagulable state, and higher reactivity of blood platelets under the influence of the use of contraceptives.

Suminski RR, Poston WSC, Foreyt JP, Jeor SS. Physical activity assessed with three different methods and the Framingham Risk Score on 10-year coronary heart disease risk. Med Sci Monit. 2008; 14(1): CR1–9.
Hurlen M, Seljeflot I, Arnesen H. Increased platelet aggregability during exercise in patients with previous myocardial infarction. Lack of inhibition by aspirin. Thromb Res. 2000; 99: 487–94.
Maruyama K, Kadono T, Morishita E. Plasma levels of platelet derived microparticlesare increased after anaerobic exercise in healthy subjects. J AtherosclerThromb. 2012; 19(6): 585–87.
Heber S, Volf I. Effects of physical (in) activity on platelet function. Biomed Res Int. 2015; Article ID 165078:1–11. http:/ /
Lamprecht M, Moussalli G, Ledinski G, Leschnik B, Schlagenhauf A, Koestenberger M, et al. Effects of a single bout of walking exercise on blood coagulation parameters in obese women. J Appl Physiol. 2013; 115(1): 57–63.
Cadroy Y, Pillard F, Sakariassen KS, Thalamas C, Boneu B, Riviere D. Strenous but not moderate exercise increases the thrombotic tendency in healthy sedentary male volunteers. J Appl Physiol. 2002; 93(3): 829–33.
Aldemir H, Kilic N. The effect of time of day and exercise on platelet functions and platelet-neutrophil aggregates in healthy male subjects. Mol Cell Biochem. 2005; 280(1–2): 119–124.
Sossdorf M, Otto GP, Claus RA, Gabriel HHW, Lösche W. Cell-derived microparticles promote coagulation after moderate exercise. Med Sci Sports Exerc. 2011; 43(7): 1169–76.
Chen YW, Chen YC, Wang JS. Absolute hypoxic exercise training enhances in vitro thrombin generation by increasing procoagulant platelet-derived microparticles under high shear stress in sedentary men. Clin Sci. 2013; 124(10): 639–49.
Chaar V, Romana M, Connes P. Effect of strenuous physical exercise on circulating cell-derived microparticles. Clin HemorheolMicrocirc. 2011; 47(1): 15–25.
Lund T, Kvernmo HD, Osterud B.Cellur activation in response to physical exercise: the effect of platelets and granulocytes on monocyte reactivity. Blood Coagul Fibrinolysis. 1998; 9(1): 63–9.
Chamberlain KG, Tong M, Penington DG. Properties of the exchangeable splenic platelets released into the circulation during exercise induced thrombocytosis. Am J Hematol. 1990; 34(3): 161–68.
Bakovic D, Pivac N, Eterovic D, Breskovic T, Zubin P, Obad A, et al.The effects of low-dose epinephrine infusion on spleen size, central and hepatic circulation platelets. Clin Physiol Funct Imaging. 2013; 33(1): 30–37.
Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy: a clinical review. Arch Intern Med. 2004; 164: 1965–976.
Vlieg AH, Helmerhorst FM, Vandenbroucke JP, Doggen CJM, Rosendaal FR. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA Case-control Study. BMJ. 2009; 339: b2921.
Lidegaard Ø, Løkkegaard E, Svendsen AL, Agger C. Hormonal contraception and risk of venous thromboembolism: national follow-up study. BMJ. 2009; 339: b2890.
Lidegaard Ø, Nielsen LH, Skovlund CW, Skjeldestad FE, Løkkegaard E. Risk of venous thromboembolism from use of oral contraceptives containing different progestogens and oestrogen doses: Danish cohort study, 2001–9. BMJ. 2011; 343: d6423.
Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vasc Biol. 2002; 22: 201–210.
Stocco B, Fumagalli HF, Franceschini SA, Martinez EZ, Marzocchi-Machado CM, de Sá MFS, et al. Comparative study of the effects of combined oral contraceptives in hemostatic variables. Medicine. 2015; 94(4): e385.
Alhenc-Gelas M, Plu-Bureau G, Guillonneau S, Kirzin JM, Aiach M, Ochat N, et al.Impact of progestagens on activated protein C (APC) resistance among users of oral contraceptives. J Thromb Haemost. 2004; 2: 1594–1600.
Weiss C, Walter B, Dorsch MF, Bärtsch P. Fibrinolytic response to exercise in women using third-generation oral contraceptives. Blood Coagul Fibrinolysis. 2006; 17: 563–68.
Jastrzębska M, Wajda P, Chełstowski K, Byra E, Sowińska-Przepiera E. Changes in some hemostatic variables during oral contraceptive use in young women; a pilot study. Diagn Lab. 2015; 51(1): 1–14.
Negrev N. Female sex hormones and thrombocytopoiesis. Eksp Med Morfol. 1990; 29(2): 57–62.
Ranganath LR, Christofides J, Semple MJ. Increased mean platelet volume after oestrogen replacement therapy. Ann Clin Biochem. 1996; 33(6): 555–60.
Kaygusuz I, Simavli SA, Eser A, InegölGümüs I, Yüksel S, IltemirDuvan ZC, et al. Effects of oral hormone replacement therapy on mean platelet volume in postmenopausal women. Turk J Med Sci. 2014; 44: 980–84.
Pina I, Balady G, Hanson P. Guidelines for clinical exercise testing laboratories. A treatment for Healtcare Professionals From the Committee on Exercise and Cardiac Rehabilitation American Heart Association. Circulation. 1995; 91: 912–21.
Hanke AA, Staib A, Görlinger K, Perrey M, Dirkmann D, Kienbaum P. Whole blood coagulation and platelet activation in the athlete: a comparison of marathon, triathlon and long distance cycling. Eur J Med Res. 2010; 15: 59–65.
Ribeiro J, Almeida-Diasb A, Ascensaoc A, Magalhaesc J, Oliveiraa AR, Carlsond J, et al. Hemostatic response to acute physical exercise in healthy adolescents. J Sci Med Sport. 2007; 10: 164–69.
Kishi Y, Ashikaga T, Numano E. Inhibition of platelet aggregation by prostacyclin is attenuated after exercise in patients with angina pectoris. Am Heart J. 1992; 123(2): 291–97.
Bain BJ. Platelet count and platelet size in males and females. Scand J Haematol. 1985; 35: 77–79.
Tarantino MD, Kunicki TJ, Nugent DJ. The estrogen receptor is present in human megakariocytes. Ann NY Acad Sci. 1994; 714: 293–96.
Nagata Y, Yoshikawa J, Hashimoto A, Yamamoto M, Payne AH, Todokoro K. Proplatelet formation of megakariocytes is triggered by autocrine-synthesized estradiol. Genes & Development, 2003; 17: 2864–869.
Köşüş N, Köşüş A, Turhan NO. Ralationship of ovarian volume with mean platelet volume and lipid profile in patients with polycystic ovary syndrome. Exp Ther Med. 2011; 2: 1141–144.
Bremme K, Hamad RR, Berg E, Strandberg K, Stenflo J. The APC-PCI concentratuion as an early marker of activation of blood coagulation. A study of women on combined oral contraceptives. Thromb Res. 2012; 130: 636–39.
Oslakovic S, Zadro R. Comparison of the impact of four generations of progestins on hemostatic variables. Clin Appl Thromb Hemost. 2014; 20: 448–55.
Paluch Z, Jedlicková V. The influence of long-term hormonal contraception and smoking an plasma concentrations of nitrites and nitrates. Med Sci Monit. 2005; 11(2): BR 61–64.
Sieminska A, Jassem E. The many faces of tobacco use among women. Med Sci Monit. 2014; 20: 153–62.
Rank A, Nieuwland R, Nikolajek K, Rösner S, Wallwiener LM, Hiller E, et al. Hormone replacement therapy leads to increased plasma levels of platelet derived microparticles in postmenopausal women. Arch GynecolObstet, 2012; 285: 1035–1041.
Toth B, Nikolajek K, Rank A, Nieuwland R, Lohse P, Pihusch V, et al. Gender specific and menstrual cycle dependent differences in circulating microparticles. Platelets, 2007; 18(7): 515–21.
Morel O, Morel N, Freyssinet JM. Toti F. Platelet microparticles and vascular cells interactions: A checkpoint between the haemostatic and thrombotic responses. Platelets. 2008; 19(1): 9–23.
Sinauridze EI, Kireev DA, Popenko NY, Pichugin AV, Panteleev MA, Krymskaya OV, et al. Platelet microparticle membrane have 50- to 100-fold higher specific procoagulant activity than activated platelets. Thromb Haemost. 2007; 97(3): 425–34.
Lippi G, Salvagno GL, Danese E, Tarperi C, Guidi GC, Schena F. Variation of red blood distribution width and mean platelet volume after moderate endurance exercise. Advances in Hematology. 2014; 2014: Article ID 192173, 4 pages.
Journals System - logo
Scroll to top