Effect of two oral contraceptives with different ethinyl estradiol and levonorgestrel concentrations on the urinary excretion of biochemical vasoactive markers

Mueck, Alfred O.; Seeger, Harald; Petersen, G.; Schulte-Wintrop, E.; Wallwiener, D.

doi:10.1016/s0010-7824(01)00287-6

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…Our findings are similar to those described for the progestin medroxyprogesterone acetate, which has been shown to antagonize estrogen-induced vasodilation in the brachial artery, forearm, and aorta (21,30,46,49). In comparison, the progestin norethisterone has not been found to antagonize estradiol in producing vasoprotective substances in vitro (38) but does decrease estrogen-induced vasodilation in the brachial artery in women with hypercholesterolemia (16). These data highlight the idea that progestin bioactivity is an important component for assessing vascular physiology in women using exogenous hormones.…”

Section: Discussionsupporting

confidence: 89%

Endothelial function across an oral contraceptive cycle in women using levonorgestrel and ethinyl estradiol

Torgrimson¹,

Meendering²,

Kaplan³

et al. 2007

American Journal of Physiology-Heart and Circulatory Physiology

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Oral contraceptive pills (OCPs) are a popular contraception method. Currently, lower-dose ethinyl estradiol formulations are most commonly prescribed, although they have been linked to increased arterial vascular risk. The aim of this study was to investigate endothelial function in healthy young women using lower-dose ethinyl estradiol OCPs. We examined flow-mediated, endothelium-dependent and nitroglycerin-mediated, endothelium-independent vasodilation of the brachial artery, comparing two doses of ethinyl estradiol/levonorgestrel OCPs in 15 healthy young women on two study days: once during the active phase and once during the placebo phase of an OCP cycle. Group low dose (LD) (n=7) active pills contained 150 microg levonorgestrel/30 microg ethinyl estradiol versus Group very low dose (VLD) (n=8) with 100 microg levonorgestrel/20 microg ethinyl estradiol. Endothelium-dependent vasodilation was lower during the active phase in Group VLD (5.33 +/- 1.77% vs. 7.23 +/- 2.60%; P=0.024). This phase difference was not observed in Group LD (8.00 +/- 0.970% vs. 7.61 +/- 1.07%; P=0.647). Endothelium-independent vasodilation did not differ between phases in either group. Finally, we measured endothelium-dependent vasodilation in two additional women who received 10 microg of unopposed ethinyl estradiol. Endothelium-dependent vasodilation was increased by unopposed ethinyl estradiol compared with the placebo phase (10.88 +/- 2.34% vs. 6.97 +/- 1.83%). These results suggest that levonorgestrel may antagonize the activity of ethinyl estradiol. Thus both the progestin type and estradiol dose need to be considered when assessing arterial vascular risk of OCP use in women.

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Section: Discussionsupporting

confidence: 89%

Endothelial function across an oral contraceptive cycle in women using levonorgestrel and ethinyl estradiol

Torgrimson¹,

Meendering²,

Kaplan³

et al. 2007

American Journal of Physiology-Heart and Circulatory Physiology

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“…Historically, vascular thrombosis risk in oral contraceptive pills users has been associated with high oral estrogen dosing (3) and the subsequent effects of oral estrogen on coagulation pathways in the vasculature (4)(5)(6)(7)(8). To date, there are few data on coagulation factors and vascular function in women using nonoral hormonal contraceptives.…”

mentioning

confidence: 99%

Endothelial Function, Endothelin-1, and Fibrinogen in Young Women Using the Vaginal Contraceptive Ring

Torgrimson

Kaplan

Minson

2008

Fertility and Sterility

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Objective-To assess the effects of the vaginal contraceptive ring cycle on indices of cardiovascular health and risk by studying healthy women during the active hormone phase compared with the ring-free phase of a standard 21/7-day cycle.Design-Observational prospective cohort; 4 weeks' duration. Setting-Department of Human Physiology, University of Oregon. Patient(s)-Twenty healthy women.Intervention(s)-Endothelial function testing using standard flow-mediated vasodilation of the brachial artery and sublingual nitroglycerin administration. All participants underwent venous blood collection.Main Outcome Measure(s)-Endothelium-dependent and endothelium-independent vasodilation of the brachial artery using Doppler ultrasound imaging. Baseline levels of highdensity lipoprotein, low-density lipoprotein, triglycerides, total cholesterol, endothelin-1, and fibrinogen. Result(s)-The active hormone phase of thevaginal ringcycle showed significantly higher vasodilation compared with the ring-free phase. The active hormone phase also showed increased fibrinogen levels compared with the ring-free phase. Low-density lipoprotein lipid levels also fluctuated and were significantly higher during the ring-free phase. Conclusion(s)-Preliminarystudy observations of improved endothelial function and lowered low-density lipoprotein levels during the active hormone phase versus the ring-free phase suggest that the vaginal contraceptive ring has beneficial effects on vascular health in women. KeywordsEstradiol; etonorgestrel; hormone delivery; vascular health; hormonal contraception; flowmediated dilation; progestin; estrogen Reprint requests to: Christopher T. Minson, Human Physiology, University of Oregon, 122 C Esslinger Hall, Eugene, OR 97403 (FAX: 541-346-7841; minson@uoregon.edu). B.T. has nothing to disclose. J.M. has nothing to disclose. N.M. has nothing to disclose. P.K. has nothing to disclose. C.M. has nothing to disclose.Presented at the 56th Annual Meeting, Pacific Coast Reproductive Society, Rancho Las Palmas Resort and Spa, Palm Springs, Florida, April 9-13, 2008. NIH Public Access Although decades of research have consistently shown that oral contraceptives increase the relative risk for vascular thromboembolic events (1-3), we know much less about nonoral hormonal contraceptives and cardiovascular risk. Historically, vascular thrombosis risk in oral contraceptive pills users has been associated with high oral estrogen dosing (3) and the subsequent effects of oral estrogen on coagulation pathways in the vasculature (4-8). To date, there are few data on coagulation factors and vascular function in women using nonoral hormonal contraceptives.The combination ethinyl estradiol/etonorgestrel monthly vaginal contraceptive ring is considered to be an advantageous route for hormone delivery compared with oral contraceptive pills (OCPs), because it avoids first-pass hepatic metabolism, allows for lower hormone doses, provides steady serum hormone levels, and requires less frequent administration. Compared with oral...

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“…The higher levels of urine creatinine and iodine excretion in women who were taking an OC might be explained by the association of OC intake with a higher GFR [13]. The vasodilatative effect of estrogen increases GFR; the natriuretic effect of synthetic progesterone predisposes to a renal loss of iodine [13, 15]. Since the spironolactone-derivative drospirenone is similar to progesterone, drospirenone-containing oral contraceptives might exert a similar effect and lead to an increased urine iodine excretion.…”

Section: Discussionmentioning

confidence: 99%

Oral Contraceptive Intake and Iodine Status in Young Women

Deischinger

Gessl

et al. 2021

Ann Nutr Metab

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Objective: Similar to pregnant women, women taking an oral contraceptive (OC) might have elevated iodine requirements due to the altered hormonal state. This is the first study aimed at investigating the prevalence of iodine deficiency and possible influences of OC intake on urine creatinine and iodine levels in young women. Methods: One hundred fifty-five women between the age of 18 and 35 years (62 taking an OC and 93 controls) participated in a cross-sectional pilot study at the Medical University of Vienna, which included a 1-spot urine sample and a questionnaire on OC intake as well as a food questionnaire. Results: The median urinary iodine concentration (UIC) in this study was 68 μg/L (41, 111 μg/L) suggesting an inadequate iodine status in the women according to the WHO guidelines. Median UIC (OC: 89 μg/L, IQR 55–120; control: 59 μg/L, IQR 39–91, p = 0.010) and urine creatinine (OC: median = 99.0 μg/L, IQR 74.9–175.5; control: 77.0 μg/L, IQR 49.6–147.2, p = 0.030) levels were significantly higher in OC women than in the control group. UIC corrected for urine creatinine was comparable between both groups. Conclusion: With similar creatinine-corrected UICs in both groups, OC intake might not have a significant impact on iodine status. However, the low median UIC in a vulnerable group of young women potentially conceiving in the following years points at the necessity of optimizing the iodine intake in the Austrian population and reiterates the insufficiency of the current iodine supplementation measures.

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Effect of two oral contraceptives with different ethinyl estradiol and levonorgestrel concentrations on the urinary excretion of biochemical vasoactive markers

Cited by 9 publications

References 22 publications

Endothelial function across an oral contraceptive cycle in women using levonorgestrel and ethinyl estradiol

Endothelial function across an oral contraceptive cycle in women using levonorgestrel and ethinyl estradiol

Endothelial Function, Endothelin-1, and Fibrinogen in Young Women Using the Vaginal Contraceptive Ring

Oral Contraceptive Intake and Iodine Status in Young Women

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