Document Detail


Effect of injectable and oral contraceptives on serum lipids.
MedLine Citation:
PMID:  19888036     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To estimate the effects of using depot medroxyprogesterone acetate (DMPA) or oral contraceptives (OCs) containing 20 micrograms ethinyl estradiol and 0.15 mg desogestrel on serum lipid levels.
METHODS: Serum lipids were measured at baseline and every 6 months thereafter for 3 years in 703 white, African-American, and Hispanic women using DMPA, OC, or nonhormonal birth control. Those who discontinued DMPA were followed for up to 2 additional years. Participants completed questionnaires containing demographic and behavioral measures every 6 months and underwent 24-hour dietary recalls annually. Mixed-model regression analyses and general-estimating-equations procedures were used to estimate changes over time in lipids by method along with their predictors.
RESULTS: Users of OCs experienced significantly greater increases in levels of triglycerides, total cholesterol, very-low-density lipoprotein (VLDL) cholesterol, and high-density lipoprotein (HDL) cholesterol than did nonhormonal-contraceptive users (P<.001). However, no difference was noted in the low-density lipoprotein (LDL) cholesterol:HDL ratio between OC users and nonhormonal-contraceptive users. Among DMPA users, HDL levels initially decreased for 6 months but then returned to baseline. The LDL:HDL ratio rose in the first 6 months of DMPA use but then dropped back to baseline over the next 24 months. After DMPA was discontinued, triglyceride, VLDL, and HDL levels were significantly higher in women who used OCs than in those who chose nonhormonal (P<.05) methods.
CONCLUSION: Use of very-low-dose OCs containing desogestrel can elevate lipid levels. Users of DMPA were at increased risk of developing an abnormally low HDL level as well as an abnormally high LDL level and an increase in the LDL:HDL cholesterol ratio, although these effects appeared to be temporary.
LEVEL OF EVIDENCE: II.
Authors:
Abbey B Berenson; Mahbubur Rahman; Gregg Wilkinson
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  114     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-11-05     Completed Date:  2009-12-02     Revised Date:  2010-12-03    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  786-94     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, the Center for Interdisciplinary Research in Women's Health, the University of Texas Medical Branch, Galveston, Texas 77555-0587, USA. abberens@utmb.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
African Americans
Cholesterol / blood
Contraceptives, Oral / pharmacology*
Desogestrel / pharmacology*
Ethinyl Estradiol / pharmacology*
European Continental Ancestry Group
Female
Hispanic Americans
Humans
Hypercholesterolemia / chemically induced*
Hypertriglyceridemia / chemically induced*
Longitudinal Studies
Medroxyprogesterone Acetate / pharmacology*
Triglycerides / blood
Young Adult
Grant Support
ID/Acronym/Agency:
K24 HD043659-01/HD/NICHD NIH HHS; K24 HD043659-02/HD/NICHD NIH HHS; K24 HD043659-03/HD/NICHD NIH HHS; K24 HD043659-04/HD/NICHD NIH HHS; K24 HD043659-05/HD/NICHD NIH HHS; K24 HD043659-06/HD/NICHD NIH HHS; K24 HD043659-07/HD/NICHD NIH HHS; K24 HD043659-09/HD/NICHD NIH HHS; K24HD043659/HD/NICHD NIH HHS; M01 RR000073-41S10528/RR/NCRR NIH HHS; M01 RR000073-42A10528/RR/NCRR NIH HHS; M01 RR000073-438696/RR/NCRR NIH HHS; M01 RR000073-447287/RR/NCRR NIH HHS; M01 RR000073-455386/RR/NCRR NIH HHS; M01RR00073/RR/NCRR NIH HHS; R01 HD039883-01A1/HD/NICHD NIH HHS; R01 HD039883-02/HD/NICHD NIH HHS; R01 HD039883-02S1/HD/NICHD NIH HHS; R01 HD039883-03/HD/NICHD NIH HHS; R01 HD039883-03S3/HD/NICHD NIH HHS; R01 HD039883-04/HD/NICHD NIH HHS; R01 HD039883-05/HD/NICHD NIH HHS; R01HD039883/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Contraceptives, Oral; 0/Triglycerides; 54024-22-5/Desogestrel; 57-63-6/Ethinyl Estradiol; 57-88-5/Cholesterol; 71-58-9/Medroxyprogesterone Acetate

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