Metabolic aspects of the new low-dose oral contraceptives
Chez, R.A.
International Journal of Fertility 34 Suppl: 50-54
1989
ISSN/ISBN: 0020-725X PMID: 2576259 Document Number: 336345
Surveying recent literature data the author describes the metabolic effects of new oral contraceptives. THe three pills, containing either desogestrel, norgestimate or gestodene in combination with estrogen, have the same efficacy as the existing low-dose combinations. They are associated with no or slight changes in glucose tolerance and appear to have reached carbohydrate metabolic neutrality. Concerning lipid metabolism, relative metabolic neutrality appears to be present in patients using combinations with gestodene or desogestrel. In several small studies, gestodene and desogestrel combinations have been associated with changes in circulating lipids that are considered favorable to the reduction of cardiovascular risk. The dominant risk factors are undoubtedly cigarette smoking, age, obesity, hypertension, glucose intolerance, family history and diet. With regard to protein metabolism, tripling of baseline levels of sex-hormone binding globulins was found with desogestrel and norgestimate, while doubling was found with gestodene. There is some preliminary evidence that plasma fibrinolytic activity is increased with gestodene and desogestrel combinations, thus no increase in coagulation-related episodes should be anticipated. All these data suggest that a high level of contraceptive efficacy with minimal systemic metabolic changes is provided by these new oral contraceptive combinations.