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A QUESTION FOR THE DOCTORSFrom: Yolande (anonymous@obgyn.net)Mon, 14 Dec 1998 02:12:12 -0600 (CST)
I have two fairly rare hereditary thrombophilic disorders- Protein C Deficiency and Factor V Leiden Mutation (activated protein c resistancy). This makes me 50 times more likely to get a DVT than a normal person. Unfortunately, I have also have very severe menstrual problems, including dysmennoreah and menorhaggia, spotting between periods etc. My menstrual cycle was causing huge disruption to my lifestyle, and analgesics provided no relief. I wanted to go on the combined pill but was strongly advised against it by my GP, physician, and gynaecologist as it would increase my already dangerous tendency to clot. My gynaecolgist advised that Depo Provera was the best option for me- whilst it is slightly contraindicated, it was not possible for me to go on having periods. Unfortunately, I have just spent a week in hospital after being diagnosed with a clot in a superficial vein in my leg (not a DVT). I am now on warfarin and will be recieving regular INR counts to monitor the dosage. A cause has been found for my clot- an opthamologist confined me to bed for three days after I suffered a hyphaema in my eye, knowing that I had a high predisposition to clotting, and taking no precautions whatsoever. In addition, two weeks earlier i underwent a hysteroscopy and D&C which went slightly overtime (30 min) and during which my legs were in stirrups. I had a local anaesthetic so I was aware of the pressure that was placed on my leg, right where the clot first appeared. The clot appeared one week after the eye injury and three weeks after the operation. My doctors and I are now faced with the decision of whether or not to continue with the depo provera (the first injection was given three and a half weeks before the clot appeared). I am told that it is generally thought that oestrogen is the hormone known to increase clotting tendency, and that progeterone does not have any affect. However, I am still undecided. To stop the depo would be debilitating as there are no other medications available to help me with my periods, but a DVT or a pulmonary embolus could be fatal. Are there gynos here who have had experience treating women who have clotting disorder sof have suffered clots who would be willing to share their opinion? Does anyone have any information or know of any studies done on progestorone in regards to clotting?
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