Metabolic profile of six oral contraceptives containing norgestimate, gestodene, and desogestrel
Teichmann, A.
International Journal of Fertility and Menopausal Studies 40(Suppl 2): 98-104
1995
ISSN/ISBN: 1069-3130 PMID: 8574257 Document Number: 445405
The changes in lipid metabolism which occur with the use of oral contraceptives (OCs) have prompted concern about the potential for OCs to increase the risk of premature atherosclerosis. Findings are reported from the study of the effects on lipid metabolism of six modern low-dose OCs. 466 women aged 18-38 years recruited from 21 study centers throughout Europe participated. Subjects were randomly assigned to the following OC formulations: norgestimate 250 mcg and 35 mcg ethinyl estradiol (EE), 180/215/250 mcg of norgestimate and 35 mcg EE, 150 mcg desogestrel and 20 mcg EE, 150 mcg desogestrel and 30 mcg EE, 75 mcg gestodene and 30 mcg EE, and 50/70/100 mcg gestodene and 30/40/30 mcg EE. There were three parallel studies with six parallel patient groups. Fasting blood samples were drawn for the analysis of cholesterol, lipoproteins, and triglycerides between days 24 and 28 and on days 18-22 of cycles 6 and 12. 282 women completed all 12 cycles and were included in the final evaluation. Triglyceride and total cholesterol concentrations increased in all study groups, but to lesser levels with the formulations containing gestodene. All OCs, except the monophasic gestodene preparation, slightly but significantly increased high-density lipoprotein (HDL) cholesterol. The HDL(2) cholesterol subfraction slightly, but significantly, decreased among women using the monophasic gestodene preparation. The low-density lipoprotein (LDL) cholesterol concentration increased slightly with the monophasic and triphasic norgestimate preparations and with desogestrel combined with 20 mcg EE. The only significant change, a slight decrease, in the LDL/HDL ratio occurred with the use of the triphasic norgestimate preparation. While all of the OCs tested altered lipid levels, after 12 cycles there were no statistically significant differences in lipid effects among OC preparations. These findings suggest that, although modern combined OCs containing norgestimate, desogestrel, or gestodene all have some impact upon lipid levels, they probably do not contribute to atherogenesis in healthy women.