Hematological Profile Changes Among Oral Contraceptive Users: A Narrative Review

Abstract

Hematological profiles are measurable indices of blood that can be used to identify and monitor some pathological and physiological abnormalities. Oral contraceptives are one of the factors which may exert an influence on hematological laboratory test results and have a critical importance. Therefore, the main goal of this review was to evaluate the hematologic profile alterations brought on by the use of oral contraceptives. Accordingly, even though there were studies that showed no significant difference, most of the oral contraceptive users had higher hemoglobin, platelet, and erythrocyte counts than non-users. Other erythrocyte metrics, such as mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and red cell dispersion width, did not significantly change. Moreover, leukocyte count and leukocyte differential count had no significant change among the oral contraceptive users in comparison to non-users. Oral contraceptive users typically have shorter prothrombin times, activated partial thromboplastin times, thrombin times, and greater levels of fibrinogen and D-dimer compared to non-users. However, this review is a narrative review and did not show the pooled effect of oral contraceptives on these hematological parameters. Therefore, it is recommended to do systematic and meta-analysis to determine the pooled effect of oral contraceptives.

Keywords:

• contraceptives
• hematological parameters
• hematopoiesis
• hemostasis
• oral contraceptives
• thromboembolism

Abbreviations

APTT, Activated Partial Thromboplastin Time; AT, Antithrombin; COC, Combined Oral Contraceptive; EC, Erythrocyte count; ERα, Estrogen Receptor-α, EVF, Erythrocyte Volume Fraction; Hb, Haemoglobin; HSC, Hematopoietic Stem Cell; MPV, Mean Platelet Volume; MCH, Mean Corpuscular Hemoglobin; MCHC, Mean Corpuscular Hemoglobin Concentration; MCV, Mean Corpuscular Volume; OC, Oral Contraceptive; PAI-1, Plasminogen Activator Inhibitor Type-1; PDW, Platelet Distribution Width; TAFI; Thrombin Activatable Fibrinolysis Inhibitor; PT, Prothrombin Time; TT, Thrombin Time; T-PA, Tissue Plasminogen Activator; RBC, Red Blood Cell; RDW, Red Cell Dispersion Width; VTE, Venous Thromboembolism; VWF, Von Willbrand Factor; WBC, White Blood Cell.

Disclosure

The authors report no conflicts of interest in this work.