{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T11:24:39Z","timestamp":1767612279476,"version":"build-2065373602"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,10,26]],"date-time":"2018-10-26T00:00:00Z","timestamp":1540512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006312","name":"South African Agency for Science and Technology Advancement","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["analyticalsciencejournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microscopy Res &amp;amp; Technique"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>There are several possible mechanisms by which combined oral contraceptives (COC) use increase venous thromboembolism (VTE) risk. Melodene\u00ae is a monophasic COC containing the third\u2010generation progestin Gestodene (GSD), which is associated with increased risk of VTE. Therefore, the aim of this study was to investigate the possible alterations in viscoelastic parameters of whole blood and plasma clots along with the biophysical characteristics of erythrocytes and specifically fibrin fibers in females using a COC containing GSD. GSD appeared to have a significant impact on the biophysical characteristics of fibrin fiber networks. When GSD is combined with ethinylestradiol the viscoelastic properties of whole blood clots tend to become more prothrombotic. The alterations to and aggregation of erythrocytes accompanied with spontaneous formation of a fibrin \u201cblanket\u201d provides a possible mechanism for the increased occurrence of \u201cred\u201d clots, which can lead to occlusions in the vascular system. Thus, the increased risk of VTE associated with these COCs can be attributed to these erythrocyte\u2010and\u2010fibrin\u2010rich\u2010clots occluding venous vessels. However, our findings also propose that these changes to the biophysical properties of both erythrocytes and fibrin, specifically spontaneous expansion of deformed fibrin networks, can also occlude vessels in the microcirculation, which could have lasting, subclinical complications for female users. We recommend that a thorough risk assessment, with specific focus on coagulation and other factors affecting fibrin formation, be done for each female before prescribing a GSD\u2010containing COC. Females that \u201cqualify\u201d then need to be monitored on a regular basis to lower the risk of thrombotic events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Research Highlights<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Gestodene in combination with ethinyl estradiol significantly impacts the biophysical characteristics of erythrocytes and fibrin fiber networks.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>These changes, specifically spontaneous expansion of deformed fibrin networks, can occlude vessels in the microcirculation, which could have lasting, subclinical complications for the female user.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The changes observed for specifically erythrocytes and fibrin show that the hormone formulation investigated contribute to a thrombogenic profile for female users<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/jemt.23149","type":"journal-article","created":{"date-parts":[[2018,10,26]],"date-time":"2018-10-26T11:01:41Z","timestamp":1540551701000},"page":"1489-1500","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hemorheological mechanisms for increased thrombosis in subjects using gestodene"],"prefix":"10.1002","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5732-5007","authenticated-orcid":false,"given":"Albe Carina","family":"Swanepoel","sequence":"first","affiliation":[{"name":"Department of Physiology, School of Medicine, Faculty of Health Sciences University of Pretoria  Arcadia South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hildegarde Cecilia","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Physiology, School of Medicine, Faculty of Health Sciences University of Pretoria  Arcadia South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashilla","family":"Soma","sequence":"additional","affiliation":[{"name":"Department of Physiology, School of Medicine, Faculty of Health Sciences University of Pretoria  Arcadia South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barend Gerhardus","family":"Lindeque","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences University of Pretoria  Arcadia South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8931-9194","authenticated-orcid":false,"given":"Janette","family":"Bester","sequence":"additional","affiliation":[{"name":"Department of Physiology, School of Medicine, Faculty of Health Sciences University of Pretoria  Arcadia South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(02)00476-6"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590500430328"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep04348"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.3.5559.214"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1966.21.1.81"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000083844"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625189709049932"},{"key":"e_1_2_6_9_1","first-page":"51","article-title":"Influence of modern low\u2010dose oral contraceptives on hemostasis","volume":"6","author":"Daume E.","year":"1990","journal-title":"Advances in Contraception"},{"issue":"5","key":"e_1_2_6_10_1","first-page":"265","article-title":"Effects of two oral contraceptives, containing 30 or 20 microg of ethinyl estradiol in combination with gestodene, on blood coagulation and fibrinolysis in Brazilian women","volume":"46","author":"Ferreira A. 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