Drospirenone-containing oral contraceptives do not affect glucose regulation and circulating corticosterone

Abstract

BackgroundCombined oral contraceptive (COC) use has been associated with an increased risk of insulin resistance (IR) and other adverse cardiovascular events, despite efforts to reduce the dosage and/or progestin type. COC containing drospirenone (DRSP) is an analog of spironolactone, hence its antimineralocorticoid and antiandrogenic characteristics have been deemed beneficial, although the benefits and/or negative outcome of its usage have not been fully elucidated. We therefore hypothesized that COC with DRSP component will not affect glucose regulation and circulating corticosterone.MethodTen-week-old female Wistar rats were divided into three groups: control (CON), ethinylestradiol/drospirenone COC (EE/DRSP)-treated, and ethinylestradiol/levonorgestrel COC (EE/LN)-treated rats. The treatment lasted for 8 weeks.ResultsResults showed that with the exception of lipid profiles, EE/LN but not EE/DRSP COC treatment affected body weight, glucose tolerance, plasma insulin, corticosterone, (IR), and pancreatic β-cell dysfunction.ConclusionTaken together, the findings showed that the beneficial effect of EE/DRSP could possibly be through the DRSP component. The result also implies that COCs containing DRSP may be a better and safer means of contraception than those with LN with less cardiovascular risks.

Evaluating the Cognitive Impacts of Drospirenone, a Spironolactone-Derived Progestin, Independently and in Combination With Ethinyl Estradiol in Ovariectomized Adult Rats

“…Furthermore, uterine weight was increased for all EE-treated rats at the end of the experiment, supporting the idea that EE stimulates uterine tissue growth, a finding we have previously reported ( Mennenga et al, 2015a ). The dose of drospirenone given in combination with EE treatments did not attenuate uterine weight at the end of the experiment, suggesting the dose given was insufficient to counter EE-induced uterine stimulation, an effect previously observed in intact rats, but not widely studied ( Adeyanju and Olatunji, 2019 ). Different ratios of drospirenone to EE will be important to investigate in future studies.…”

Investigating cardiovascular risk in premenopausal women on oral contraceptives: Systematic review with meta-analysis

“…They are involved in the regulation of other body functions besides the control of the body's osmotic balance, respiratory and blood pressure regulation, sodium homeostasis, kidney functioning ( 80 ), fear conditioning, and love making ( 81 – 83 ). It is noteworthy that the synthetic progestins, apart from acting at the PR, can also influence the activity of other steroid receptors to induce androgenic, glucocorticoid, antiandrogenic, and antimineralocorticoid effects ( 84 , 85 ).…”

The benefits of estetrol addition to drospirenone for contraception

“… 92 Preclinical studies suggest that COCs containing DRSP are likely safer than those with LNG because of less insulin resistance, pancreatic β-cell dysfunction, glucose deregulation, dyslipidemia, and circulating corticosterone. 93 Clinical studies with DRSP alone or with E4-DRSP have demonstrated a good cardiovascular safety profile. 53 , 56 DRSP alone and E4-DRSP also showed limited impact on lipid parameters, 54 , 55 whereas with the addition of EE to DRSP, lipid parameters, such as triglycerides, increased by 66% from baseline after 6 cycles of usage.…”