Coagulation Alterations in Single Women using Oral and Injectables Contraceptives in Calabar: Implications for Thromboembolic Risk and Policy Regulation

Background and Objective: Hormonal contraceptives have been reported to influence haemostatic parameters, potentially increasing the risk of thrombotic events. This study assesses PT, APTT, TT, and FIB of single women using some form of contraceptives in Calabar, Cross River State, Nigeria. Materials and Methods: A cross-sectional descriptive study and a well-filled questionnaire were used. A citrated sample was obtained from 198 females, grouped into 98 single women on contraceptives and 100 single women not on contraceptives, of age range 15-30 years in Calabar, Cross River State, Nigeria. The single women were on oral 42 (42.9%) progestogen-only pills (POPs) 22 (52.4%), combined oral contraceptives (COCs) 20 (47.6%), POIs = Progestogen-only injectibles (POIs) 56 (57.1%) [Depo-Provera 36 (64.3%) and Noristerat 20 (35.7%)]. Quick’s one-stage was used for PT, APTT, and TT (Helena Bioscience), while Clauss’s Method was used to assess Fibrinogen levels. Ethical Clearance was obtained. Data were analysed using SPSS v20 with significance set at p<0.05. Results: The Mean±SD of PT, FIB, and TT (12.8 sec, 2.7 g/L, and 12.61 sec) was shown to be significantly higher and reduced in single women on contraceptive when compared to single women not on contraceptive (12.3 sec, 2.5 g/L, and 14.41 sec), p<0.05, respectively. Meanwhile, there was a statistically significant progressive increase in PT and FIB levels, while APTT and TT decrease (p<0.05) in single women on contraceptive when age (15-20, 21-25 and 26-30 years), duration (<1 year, 1-3 years and >4 years) of intake and types of contraceptives (FIB) was considered. Women on progestogen-only injectables recorded the highest fibrinogen levels. Fibrinogen showed significant moderate positive correlations with PT, APTT, and TT (p<0.05). Conclusion: Abuse of long-term use of contraceptives raises the risk for blood clots or incessant bleeding as it causes changes in the PT, FIB, APTT, and TT levels of single women in Calabar. These changes are more pronounced with injectable formulations. Policies should be made that regulate who sells contraceptive devices to avoid their nonprescription it in our society.