A Prospective, One-Year Study on the Effects of Two Long Acting Injectable Contraceptives (Depot-Medroxyprogesterone Acetate and Norethisterone Oenanthate) on Serum and Lipoprotein Lipids

Abstract

Two parenterally administered progestins (depot medroxyprogesterone acetate, DMPA, 150 mg/12 weeks and norethisterone oenanthate, NET, 200 mg/8 weeks respectively) were given to women seeking contraceptive advice. Before treatment and after 1, 6, 7, 12 and 13 months blood samples were taken. In serum and in the ultracentrifugally separated lipoprotein fractions the levels of total and free cholesterol, triglycerides and phospholipids were assayed, as were the apolipoprotein A1 and B levels in serum. At the end of the study NET had induced a decrease in all lipid components of the HDL (high density lipoprotein) fraction of approximately 30% and tended to increase LDL (low density lipoprotein) lipids. DMPA also decreased HDL-lipids, approximately 15%. There was also a transient decrease in apolipoprotein A1 after one month in both patient groups. From epidemiological studies it is inferred that low HDL-levels and high LDL-levels are independent risk factors for the development of atherosclerosis and cardiovascular disease. Thus our findings might indicate an adverse effect in this respect of long term treatment with these progestins, particularly with NET.

Long-Term Use of Contraceptive Depot Medroxyprogesterone Acetate in Young Women Impairs Arterial Endothelial Function Assessed by Cardiovascular Magnetic Resonance

“…DMPA users presented with lower cholesterol levels than controls, which may be a direct effect of DMPA. 23 It is possible that DMPA-induced metabolic changes may have had adverse effects on the endothelium in our study.…”

A Comparative Analysis of Three Methods of Contraception: Effects on Blood Glucose and Serum Lipid Profiles

“…Similar effects have been observed for injectable contraceptives by other investigators. 8,10 The variable effects of oral contraceptive pills on plasma lipids and blood glucose levels depend on their relative estrogen and progestin content, as well as their specific progestin component. 11,12 Although varying degrees of elevation of plasma lipids have been reported with the use of the older combination OCs, 11 the newly developed monophasic and triphasic ethinyl estradiol/norgestimate preparations have consistently shown a favorable impact on these metabolic parameters, especially the HDL level and LDL/HDL ratios.…”

Effect of hormonal contraceptives on lipid profile and the risk indices for cardiovascular disease in a Ghanaian community

“…DMPA is said to increase LDLC and decrease HDLC 11. Additionally, glucose metabolism is affected by decreasing glucose tolerance over time;12 increasing insulin resistance and decreasing beta cell function 13.…”