The effects of two monophasic oral contraceptives containing 30 mcg of ethinyl estradiol and either 2 mg of chlormadinone acetate or 0.15 mg of desogestrel on lipid, hormone and metabolic parameters

Winkler, Ulrich; Sudik, R

doi:10.1016/j.contraception.2008.08.011

Cited by 47 publications

(26 citation statements)

References 31 publications

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“…According to the National Cholesterol Education Program, elevated LDL-C levels are the major cause of CHD (19). The reason for the differences in the LDL-C parameters in the DSG group compared with previous studies (10, 20, 22,23, 27) might have resulted from the participation of overweight and obese women in this study, who are at higher risk for dyslipidemia, including decreased HDL-C and increased LDL-C and TG (14). …”

Section: Discussionmentioning

confidence: 68%

Effects of Second and Third Generation Oral Contraceptives on Lipid and Carbohydrate Metabolism in Overweight and Obese Women: A Randomized Triple-Blind Controlled Trial

Shahnazi

Farshbaf‐Khalili

Pourzeinali

et al. 2016

Iran Red Crescent Med J

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BackgroundCombined oral contraceptives (COCs) have not been shown to have major effects on lipid and carbohydrate metabolism in normal-weight women. However, we have limited information about the effects on women at high risk for cardiovascular disease and diabetes due to being overweight and obese.ObjectivesTo evaluate the effects of second and third generation contraceptive pills on lipid and carbohydrate metabolism in overweight and obese women.Patients and MethodsThis triple-blind controlled trial was performed on 137 healthy women aged 18 - 40 years with a body mass index of 25-34.9 (kg/m2) who were referred to health centers in Tabriz, Iran from 2014 to 2015. The women were randomly divided into groups who were to take 30 mcg ethinyl estradiol/150 mcg levonorgestrel (EE/LGN) (n = 69) or 30 mcg ethinyl estradiol/150 mcg desogestrel (EE/DSG) (n = 68) with an allocation ratio of 1: 1 for three cycles. As primary outcomes, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and fasting plasma glucose (FPG) were assessed; total cholesterol (TC), triglycerides (TG), and 2-hour plasma glucose in the 75-g oral glucose tolerance test (2-hour 75-g OGTT) were assessed as secondary outcomes.ResultsThe differences in lipid and carbohydrate parameters were not significant between the two groups, except for HDL-C (Adjusted MD (CI95%) = 7.00 (2.98 to 11.02)). HDL-C decreased with EE/LGN (P = 0.016) and increased with EE/DSG (P = 0.004). LDL-C and TC increased in both groups, whereas TG increased only with EE/DSG (P < 0.05). Compared with the baseline, FPG levels did not differ significantly in both groups, but EE/DSG increased 2-hour 75-g OGTT (P = 0.010).ConclusionsWe observed no significant differences between the two groups in lipid and carbohydrate metabolism, except for HDL-C. Considering the importance of overweight and obese women’s health, studies with longer follow-up periods are recommended in this respect.

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Section: Discussionmentioning

confidence: 68%

Effects of Second and Third Generation Oral Contraceptives on Lipid and Carbohydrate Metabolism in Overweight and Obese Women: A Randomized Triple-Blind Controlled Trial

Shahnazi

Farshbaf‐Khalili

Pourzeinali

et al. 2016

Iran Red Crescent Med J

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“…17, 18 Hormonal contraceptives have, for many women, unintended metabolic effects, including elevated levels of very low-density lipoprotein cholesterol and total triglycerides. 15, 19–21 Hormonal contraceptives increase plasma insulin and cortisol, 21 and induce a state of insulin resistance. 15, 19, 20 Some of these metabolic changes, including increased total cholesterol 22 and insulin resistance, 23 are similar to those in women who are overweight or obese..…”

Section: Introductionmentioning

confidence: 99%

Maternal hormonal contraceptive use and offspring overweight or obesity

et al. 2014

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Objective Experiments in animal models have shown a positive association between in utero exposure to pharmacologic sex hormones and offspring obesity. The developmental effects of such hormones on human obesity are unknown. Methods Using data from a large, prospective pregnancy cohort study (n=19,652), with linkage to a national prescription registry, we evaluated the association between use of hormonal contraceptives before and after conception (defined from dispensed prescription data and characterized by last date of use relative to conception, 12 – >4 months before (n=3,392), 4 – >1 months before (n=2,541), 1 – > 0 months before (n=2,997), and 0–12 weeks after (n=567)) in relation to offspring overweight or obesity at age 3 years. Results We observed a weak, inverse association between early pregnancy use of a combination oral contraceptive and offspring overweight or obesity at age 3 (adjusted OR: 0.75, 95% CI: 0.53, 1.08) and a positive, but imprecise, association with use of a progestin-only oral contraceptive in early pregnancy (adjusted OR: 1.26, 95% CI: 0.79, 2.02). In general, no association was observed between use of a hormonal contraceptive before conception and offspring overweight or obesity. A sensitivity analysis comparing combination oral contraceptive users in early pregnancy to other unplanned pregnancies without hormonal contraceptive use further strengthened the inverse association (adjusted OR: 0.70, 95% CI: 0.48, 1.02). Other sensitivity analyses were conducted to evaluate the robustness of the associations observed given varying assumptions. Conclusion Pharmacologic sex hormones in early pregnancy may be inversely or positively associated with offspring overweight or obesity at age 3, depending on the specific formulation used. The present study provides support for the potential for environmental sources of hormonally active agents to exert developmental effects.

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“…For example, while desogestrel has been shown to increase HDL levels, levonorgestrel can cause a reduction in HDL [17]. Modern hormonal contraceptives have sought to minimize the androgenic quality of progestins to mitigate any metabolic effects [16][17][18]. Newer third progestins generation progestins (gestodene and desogestrel) have a negligible effect on lipoprotein metabolism and do not suppress the positive impact of estrogen [19].…”

Section: Glucose and Lipidsmentioning

confidence: 99%

Safety and efficacy of contraception—Why should the obese woman be any different?

Rodríguez

Edelman

2011

Rev Endocr Metab Disord

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The public health impact of obesity and unintended pregnancy is profound with far reaching consequences. Obese women are less likely to use contraception due to a variety of self-induced and systems-based barriers but their risk of becoming pregnant is similar to their normal weight counterparts. However, pregnancy-associated risks for obese women are higher than that of normal weight women and thus, pregnancy generally outweighs the risks of contraceptive use. Adequate counselling to prevent and/or plan for pregnancy is imperative for these women. Research that investigates the relationship between obesity and contraceptive use is urgently needed.

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The effects of two monophasic oral contraceptives containing 30 mcg of ethinyl estradiol and either 2 mg of chlormadinone acetate or 0.15 mg of desogestrel on lipid, hormone and metabolic parameters

Cited by 47 publications

References 31 publications

Effects of Second and Third Generation Oral Contraceptives on Lipid and Carbohydrate Metabolism in Overweight and Obese Women: A Randomized Triple-Blind Controlled Trial

Effects of Second and Third Generation Oral Contraceptives on Lipid and Carbohydrate Metabolism in Overweight and Obese Women: A Randomized Triple-Blind Controlled Trial

Maternal hormonal contraceptive use and offspring overweight or obesity

Safety and efficacy of contraception—Why should the obese woman be any different?

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