Background: Hormonal contraception plays a pivotal role in modern family planning and reproductive health. Despite its widespread use, concerns persist regarding its potential effects on hematological and hemostatic balance, particularly in low- and middle-income settings where baseline biological profiles and monitoring practices may differ. Objective: To evaluate the hemostatic profile of women using hormonal contraception in Ebolowa, Cameroon, and to compare these parameters with those of non-users. Methods: A prospective case-control study was conducted among 210 women aged 18 - 45 years, including 75 hormonal contraceptive users and 135 non-users at the Ebolowa Regional Hospital (ERH) and the Ebolowa Regional Hospital Center (ERHC) from January 2025 to June 2025. Hemoglobin level, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR) were measured using standardized laboratory procedures on a STAGO automated analyzer. Statistical analyses were performed to assess differences between groups. Results: Compared with non-users, women using hormonal contraception exhibited a significantly lower mean hemoglobin level (10.79 ± 1.38 g/dL vs 11.29 ± 1.70 g/dL) and a markedly higher platelet count (403.8 ± 162.6 G/L vs 273.2 ± 106.4 G/L; p < 0.05). Hemostatic assessment revealed a significant increase in PT, a prolongation of aPTT, and a moderate decrease in INR among contraceptive users. These changes were more pronounced among users of combined oral contraceptives and injectable progestins. Conclusion: Hormonal contraceptive use is associated with significant yet subclinical alterations in hematological and hemostatic parameters, suggesting a compensated procoagulant state. These findings underscore the importance of context-specific biological monitoring and support the integration of basic hemostatic evaluation into contraceptive follow-up, particularly for women with additional thromboembolic risk factors.
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