Quote from: Sophia Sage on November 03, 2016, 07:56:02 AM
I'd think the rationale behind the practice is not to stop excessive bleeding, but to reduce DVT. Estrogen increases clotting (which is why it skyrockets not just in pregnant women, but in all kinds of pregnant mammals, so that giving birth can be survived).
Skyrockets? Exaggeration.
Curr Opin Obstet Gynecol. 2014 Dec;26(6):469-75.« Venous thromboembolism is, in the developed world, a major cause of maternal morbidity and mortality during pregnancy or early after delivery, with a reported incidence ranging from
0.49 to 2.0 events per 1000 deliveries."
In other words, ABSOLUTE risk is 0.05-0.2%. Despite estradiol levels being as high as 75,000 pg/ml (
http://cebp.aacrjournals.org/cgi/content-nw/full/12/5/452/T1 ).
Add to this that,
Ann Intern Med. 2005 Nov 15;143(10):697-706.« The relative risk (standardized incidence ratio) for venous thromboembolism among pregnant or postpartum women was 4.29 (95% CI, 3.49 to 5.22;P < 0.001), and the overall incidence of venous thromboembolism (absolute risk) was 199.7 per 100,000 woman-years.
The annual incidence was 5 times higher among postpartum women than pregnant women (511.2 vs. 95.8 per 100,000), and the incidence of deep venous thrombosis was 3 times higher than that of pulmonary embolism (151.8 vs. 47.9 per 100,000).
Pulmonary embolism was relatively uncommon during pregnancy versus the postpartum period (10.6 vs. 159.7 per 100,000). "
"Among pregnant women, the highest risk period for venous thromboembolism and pulmonary embolism in particular is during
the postpartum period."
Risk of thromboembolism during pregnancy is therefore 0.1%, with risk of pulmonary embolism being 0.01%. Very very low incidence despite VERY high levels of E2.
I am on injectable bio-identical estradiol and I don't need to stop regardless of the surgical intervention as my clotting times remain normal. My E2 levels range anywhere from 1,000 - 4,000 pg/ml. The route of administration and type of estrogen (bio-identical) appear to play a crucial role in the effects on coagulation.
Prostate 1989;14(4):389-95
Estrogen therapy and liver function--metabolic effects of oral and parenteral
administration."The impact of exogenous estrogens on the liver is dependent on the route
of administration and the type and dose of estrogen. Oral
administration of synthetic estrogens has profound effects on
liver-derived plasma proteins, coagulation factors, lipoproteins, and
triglycerides, whereas parenteral administration of native estradiol
has very little influence on these aspects of liver function."
I didn't stop taking estrogen (was bio-identical, sublingual) before my SRS or gallbladder removal surgery. Some doctors like Dr. Marci Bowers don't require you stop estrogen. Some anti-androgens need to be stopped, however. This needs to be discussed with a doctor who has an extensive knowledge of these matters.
