Biological Effects of Eleven Combined Oral Contraceptives on Serum Triglycerides, γ-Glutamyltransferase, Alkaline Phosphatase, Bilirubin and other Biochemical Variables

Abstract

The objectives of this paper are to update and quantify the biological effects of the most commonly used oral contraceptives (OC) on 15 biochemical tests currently determined in clinical laboratories and to compare these effects between the different types of OC. The sample population was constituted by 1604 women using combined OCs and the control group comprised 3466 women in the same age range not taking medication. Women taking OC were divided into 11 groups according to the estrogen/progestogen combination. The effects of OCs were studied after adjustment for age, weight, height, body mass index and alcohol and tobacco consumption. The changes observed with the new progestogens were less important than in the past. In comparison with the controls, the mean serum triglyceride concentration was significantly increased by +8.5% to +36.0% (p<0.05 to p<0.001) in each group while those of total cholesterol and gamma-glutamyltransferase were increased only in 3 and 4 estrogen/progestogen combinations respectively. Conversely, the mean concentrations of alkaline phosphatase, total bilirubin, phosphate and albumin were significantly decreased. Using a discriminant analysis, three main groups according to the type of progestogen were defined: cyproterone acetate, DL-norgestrel and levonorgestrel, and all other progestogens. The changes in serum triglyceride concentration induced by OC intake must be considered by the clinician and are useful for taking a clinical and risk decision in an individual woman.

Effect of Oral Contraceptive Pills on the Blood Serum Enzymes and DNA Damage in Lymphocytes Among Users

“…Steroid hormones have been reported to increase aminotransferases among OC users [48,49]. In our earlier study with triglycerides, HDL and LDL, the level of serum markers were found to be high among users [50]. Thus, it is concluded that the intake of OC affects the level of various blood serum enzymes and it may depends on the estrogens and progestin dosage or the androgenic activity of the progestin [51].…”

Ethinylestradiol/cyproterone acetate in polycystic ovary syndrome: lipid and carbohydrate changes

“…Oral contraceptives have also demonstrated efficacy in preventing dysfunctional bleeding, but their effect on acne or hirsutism is variable, as well as on lipid and carbohydrate metabolism 21,22 . Our special interest in the oral contraceptive combination of EE/CPA lies in the antiandrogenic properties of cyproterone acetate, since the negative effects of progestins on lipid and carbohydrate metabolism are related to their androgenic potency 21,22 .…”

“…Our special interest in the oral contraceptive combination of EE/CPA lies in the antiandrogenic properties of cyproterone acetate, since the negative effects of progestins on lipid and carbohydrate metabolism are related to their androgenic potency 21,22 .…”

“…The estrogen acts favorably on the cholesterol profile, but increases triglycerides; the progestin acts in the opposite way 21,22 . Regarding carbohydrate metabolism, both ethinylestradiol and progestins can worsen insulin resistance 21,23 .…”

“…Regarding carbohydrate metabolism, both ethinylestradiol and progestins can worsen insulin resistance 21,23 . The progestin effect, both on lipid and carbohydrate metabolism, is related to its androgenic action, being more intense with more androgenic potential of the progestin 21,22 . Since cyproterone acetate is an antiandrogenic progestin, it is interesting to investigate the final balance in lipid and carbohydrate metabolism with this steroid combination treatment.…”