Randomized Prospective Studies on Metabolic Effects of Oral Contraceptives

Abstract

Abstracf. The results of two randomized prospective studies on metabolic changes induced in groups of healthy Young women by commercial oral contraceptives (OC) are described. In the first study, four low-estrogen (30 pg or 35 pg ethinylestradiol) combined products were compared, while in the second, effects of four different formulations, each containing levonorgestrel plus ethinylestradiol, were determined. Results are presented for oral glucose tolerance and plasma insulin responses, serum total cholesterol, HDLcholesterol, triglycerides, coagulation factors I, VII, VIII, and x, plasminogen, anti-thrombin 111, and (for study no. two only) renin activity, substrate, and concentration. In

Renin-Angiotensin-Aldosterone System in Women Using Combined Oral Contraceptive: A Systematic Review

“…Possibly, the elevation of PRA is accompanied by a decrease in its concentration. However, the fact that our study had a lower EE dosage (15 to 30mcg 7 Vs 50mcg 12 ( with longer use (3 years 7 Vs 1 year 12 ), may have influenced the values of increased plasma renin oncentrations while their activity was normal. It is difficult to know because this has not been verified.…”

“…7 The reasons that justify this opposition between the aforementioned studies are unknown. One hypothesis is the difference in the dosage and time of use of the COCs used in the studies, since the mean age of the selected samples were similar (23 years 7 vs 24 years 12 ). Possibly, the elevation of PRA is accompanied by a decrease in its concentration.…”

Oral Contraceptive Pills and Hypertension: A Review of Current Evidence and Recommendations

“…In a randomized, prospective study of 72 individuals, plasma angiotensinogen levels doubled among individuals taking CHCs containing ethinyl estradiol 50mcg, while levels increased by approximately 12% to 20% among those taking OCPs containing ethinyl estradiol 30 to 35 mcg. 69 Downstream renovascular effects including higher renal vascular resistance, lower renal blood flow, and higher filtration fraction have also been noted among individuals taking OCPs. 66,70,71 Administration of RAAS blocking agents to these individuals attenuated these changes, suggesting that the renovascular effects are RAAS mediated.…”

A Prospective Study of Insulin Sensitivity and Glucose Metabolism in Women Using a Continuous Subdermal Levonorgestrel Implant System

“…Numerous other studies have likewise reported a deterioration in oral glucose tolerance curves and hyperinsulinemia, which is related to dosage and is especially associated with the 19-nortestosterone derivatives (norgestrel, levonorgestrel, and desogestrel). [2][3][4][5][6][7][8][9][10][11][12][13] Studies of insulin sensitivity using euglycemic clamp, insulin suppression techniques, or a frequently sampled 3-hour intravenous glucose tolerance test (FSIGT) with a mathematical minimal modeling approach have reported some degree of decreased insulin sensitivity in oral contraceptive agent users. 1 1 The need for an effective, long-temi, estrogen-free hormonal contraceptive led to the development of a progestinonly subdermal implant system (Norplant; Wyeth-Ayerst Laboratories, Philadelphia.…”