Steroidal contraceptives and changes in individual plasma phospholipids: possible role in thrombosis

Abstract

The changes in the levels of individual phospholipids were studies in women during prolonged use of three types of steroidal contraceptive preparation: high-dose combined pills (Noriday 1 + 50 Fe); low-dose combined pills (Nominest Fe) and progestin-only injectables (Depo-Provera). Women on high-dose combined pills had significantly higher (p less than 0.05) mean lysophosphatidylcholine (LPC), sphingomyelin (SPH), phosphatidylserine (PS) and phosphatidylethanolamine (PE) levels, respectively, than the women on low-dose combined pills, progestin-only injectables and the controls, respectively. Women on low-dose combined pills had significantly lower (p less than 0.01) mean LPC and PS levels, respectively, than the controls, while women on progestin-only injectables had significantly lower (p less than 0.01) mean PS and PE levels, respectively, than the controls. Based on the reported high activities of PS and PE in hemostasis, the PE/total plasma phospholipids, PS/total plasma phospholipids and the sum of PE and PS/total plasma phospholipids ratios were calculated to assess the possible overall effect of the changes in plasma phospholipids in steroidal contraceptive users. The results obtained using these indices agree with some earlier reports of an estrogen dose-dependent risk/incidence of thrombosis in steroidal contraceptive users. It is concluded that the observed dose-dependent estrogen-induced alterations in phospholipids, and, most especially, the PE and PS fractions may bear a relationship with thrombotic conditions.

Exposure to Oral Contraceptives Alters Human Endometrial Stem Cells Culture Media Metabolomics

“…Although little is known concerning the effect of OC in phospholipids and sphingolipids in EnMSC metabolism, high concentration of sphingomyelin and lysophosphatidylcholine in plasma was associated with the use of high-dose combined OC pills and the risk of thrombosis (Oyelola et al, 1990). In contrast, we found a higher concentration of sphingomyelin and phosphatidylcholine in the non-OCP group, suggesting that low-dose OC may not interfere with metabolite homeostasis in the same manner as high-dose OC.…”

Decreased plasma sensitivity to activated protein C by oral contraceptives is associated with decreases in plasma glucosylceramide

“…Thus, the relationship between the change in the endogenous GlcCer level and the change in the ratio induced by OCs was very similar to the relationship observed when endogenous plasma GlcCer is specifically hydrolyzed by glucocerebrosidase. As OC may also affect other factors including other plasma lipids level [16–19], it is possible that other factors which change in parallel with GlcCer may also contribute to or be responsible for the OC effect. However, our data indicate that a decreased level of plasma GlcCer may, in some part, contribute to a reduction in plasma sensitivity to APC/protein S during OC usage.…”