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Exercise increases hemostatic and fibrinolytic activity in humans. The same has been reported for oral contraceptive agents (OCA). We studied the combined effects of strenuous exercise and OCA in twenty highly trained female athletes. Ten of the subjects had been using the pill (30 meg ethinylestradiol) for more than a year (users). The other ten females not using OCA served as a control (non users). All subjects were exercised to exhaustion which was attained within 10-16 min. by means of an increasing workload test on a bicycle ergometer. Tests were performed during morning hours and only in the first half of the therapeutic or menstrual cycle. Hemostatic and fibrinolytic components were determined in pre and postexercise plasma samples. Changes in plasma volume that occurred with exercise were calculated and postexercise results were corrected for these changes. Procoagulant activity of Factors XII, XI and VII were determined using partial thromboplastin time assays. HMWK, α2-macroglobulin and Ci-INH were quantified by an immunodiffusion technique using monospecific antisera. Synthetic chromogenic peptide substrates were used for the determination of plasminogen, prekallikrein,α2 antiplasmin and AT III amidolytic activities. Comparison or resting values showed an increase in F XII and plasminogen concurrent with a decrease in Cl-INH level in the group of users. The combination of exercise and OCA induced a decrease of all plasma components except F VII in the users. Postexercise decreases in F XII, HMWK, prekallikrein and they two inhibitors α2-macroglobulin and α2-antiplasmin were seen in the non users. Results indicate that hemostatic and fibrinolytic changes due to strenuous exercise are potentiated by OCA in trained females. The relevance of corrections for changes in plasma volume is demonstrated.

The Effect Of Exercise And Oral Contraceptive Agents On Hemostatic And Fibrinolytic Mechanisms In Trained Athletes