Metabolic effects of the continuous use of an oral contraceptive containing ethinyl-estradiol and gestodene

Metabolic effects of the continuous use of an oral contraceptive

containing ethinyl-estradiol and gestodene

R.B. Machado, P. Fabrini, E.M.C. Maia, F.G. Tachotti, D.B. Milano, A.M. Cruz

Department of Gynecology and Obstetrics, Faculty of Medicine, Jundiaí,

São Paulo, Brazil

Objective: The objective of this study was to evaluate the impact of

the continuous use of a contraceptive association containing ethinyl-estradiol

and gestodene on lipid profiles, carbohydrates and coagulation.

Methods: A total of 32 patients with a mean age of 25.0+3.7 years were

evaluated in a prospective, open, non-comparative study. Patients received the

contraceptive combination of ethinyl-estradiol 30 mcg and gestodene 75 mcg

continuously for six consecutive months. Plasma measurements of total

cholesterol, HDL, LDL, triglycerides, insulin, glucose, antithrombin-III,

fibrinogen, PAI-1, protein C and protein S were carried out before and after

treatment. Results were expressed as means and standard deviations of the

biochemical parameters evaluated at the beginning and at the end of the study.

Student’s t-test for paired samples was used in the statistical analysis, and

significance level was established at 5%.

Results: After six consecutive months of use of the contraceptive pill,

HDL levels showed a significant increase (p=0.001). No significant changes were

seen in the levels of total cholesterol, LDL or triglycerides. There was a

slight increase in plasma levels of insulin (p=0.059) and glucose measurements

remained practically unaltered. With respect to coagulation and fibrinolysis

parameters, a significant increase was registered in the levels of fibrinogen

and PAI-1 (p=0.042 and p=0.003, respectively), an increase, although not

significant, in antithrombin-III and a reduction, also not significant, in

protein C and protein S.

Conclusions: The continuous use of the combination of

ethinyl-estradiol/gestodene was associated with beneficial changes to the lipid

profile, as well as a slight increase in insulin levels, fibrinogen and PAI-1.

These results are comparable to those found with the use of the regular standard

oral contraceptive pill regimen with a 7-day pill-free interval.

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