A randomized study over 13 cycles to assess the influence of oral contraceptives containing ethinylestradiol combined with drospirenone or desogestrel on carbohydrate metabolism

Abstract

In this open-label, randomized study we compared the influence of a new oral contraceptive containing 30 µg ethinylestradiol and 3 mg drospirenone (Yasmin™) with a reference preparation containing 30 µg ethinylestradiol and 150 µg desogestrel (Marvelon™) on variables of carbohydrate metabolism by means of oral glucose tolerance tests at baseline and in the 6th and 13th treatment cycle. The mean levels of fasting glucose and insulin were similar at baseline and after 13 treatment cycles, whereas C-peptide and free fatty acid levels decreased slightly in both groups. All blood glucose and insulin values measured in the oral glucose tolerance tests were within normal ranges, despite a slight increase in the mean areas under the curves of 0-3 h [AUCs (0-3 h)] of both variables from baseline to treatment cycle 13. Differences between both treatments were not statistically significant. The mean AUCs (0-3 h) for C-peptide were not markedly changed in any treatment group. Free fatty acid levels decreased by 42% in the drospirenone group and increased by 48.9% in the desogestrel group, in terms of means of individual changes. Both preparations were well tolerated and equally efficacious regarding contraception and cycle control. The mean body weight was slightly decreased in most cycles during treatment with the drospirenone combination, as compared to baseline, while it was slightly increased versus baseline in all cycles during treatment with the desogestrel combination. The combination with drospirenone had less impact on blood pressure than the combination with desogestrel. In conclusion, Yasmin, a combined low-dose oral contraceptive with 30 µg ethinylestradiol and 3 mg of the novel progestogen drospirenone, as well as the reference Marvelon, containing 30 µg ethinylestradiol and 150 µg desogestrel had little impact on carbohydrate metabolism when used for 1 year. The observed changes were small and not suggestive of a clinically relevant deterioration of carbohydrate metabolism.

A combined oral contraceptive containing 30 mcg ethinyl estradiol and 3.0 mg drospirenone does not impair endothelium-dependent vasodilation

“…In contrast, drospirenone has demonstrated positive effects on lipid profiles including increasing HDL [42, 45, 46] and decreasing LDL [42, 46]. We did not observe these same changes across an OCP cycle in the current study.…”

The effects of oral contraceptives including low-dose estrogen and drospirenone on the concentration of leptin and ghrelin in polycystic ovary syndrome

“…While the carbohydrate metabolism was not affected significantly in this and various studies with EE and DRSP therapy (22,23,28), some studies showed a moderate impairment of glucose tolerance (26,29).…”

Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring. A prospective, randomized, pilot study

“…Drospirenone is a 17a-spirolactone derivative progestin that combines a potent progestogenic activity with antiandrogenic and antimineralocorticoid activity. The latter, by counteracting the stimulating action exerted by EE on the renin-aldosterone system, may reduce blood pressure (5). However, like other OCs, the pills containing drospirenone present such disadvantages as a requirement for daily administration, fluctuations in plasma contraceptive concentrations, hepatic first-pass metabolism, and potential gastrointestinal interference with absorption.…”