Effect of long-acting progestagen-only injectable contraceptives on carbohydrate metabolism and its hormonal profile.
Two groups, each composed of 20 women, who used depomedroxyprogesterone acetate (DMPA) or norethisterone enanthate (NET-EN) injectable contraceptives were investigated for changes in 75-g OGTT and in the fasting and two-hour post oral glucose load (2-hours) levels of serum insulin, growth hormone, glucagon, cortisol and blood pyruvate. Samples were taken before and 3, 6 and 12 months after use of injectables. DMPA and NET-EN caused significant changes in mean blood glucose and pyruvate and in mean serum insulin, growth hormone and glucagon, but not in mean fasting cortisol. Changes with NET-EN started after 3 months, became maximal after 6 months and reverted to normal after 12 months of use, due to more frequent administration during the first 6 months of use (every 60 +/- 5 days) and to more spacing of the injections (every 84 +/- 5 days) after that. Changes with DMPA started after 3 months, and increased with the duration of use to become maximal after 12 months. Maximal changes were similar with DMPA and NET-EN and consisted of: a significant increase in fasting blood glucose and pyruvate and serum insulin; a significant increase in 2-hour blood glucose and pyruvate, serum insulin, growth hormone and glucagon. Although significant changes in blood glucose levels occurred with both DMPA and NET-EN, yet they did not reach the lower cut-off levels for impaired glucose tolerance in any user. With the same spacing of injections, i.e. every 84 +/- 5 days for NET-EN and every 90 +/- 5 days for DMPA, the effects on various parameters studied were less with NET-EN.
Fahmy
K
K
Department of Obstetrics and Gynecology, Benha Faculty of Medicine, Cairo, Egypt.
Abdel-Razik
M
M
Shaaraway
M
M
al-Kholy
G
G
Saad
S
S
Wagdi
A
A
al-Azzony
M
M
D001786:Blood Glucose / Q000378:metabolism; D050260:Carbohydrate Metabolism; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000494:pharmacology* / Q000592:standards; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage / Q000494:pharmacology* / Q000592:standards; D003692:Delayed-Action Preparations; D005260:Female; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007328:Insulin / Q000097:blood*; D008525:Medroxyprogesterone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000592:standards; D017258:Medroxyprogesterone Acetate; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000592:standards; D011773:Pyruvates / Q000097:blood*; D011863:Radioimmunoassay; D013997:Time Factors
D001786:Blood Glucose; D003271:Contraceptive Agents, Female; D003280:Contraceptives, Oral, Synthetic; D003692:Delayed-Action Preparations; D007328:Insulin; D011773:Pyruvates; D013006:Growth Hormone; D017258:Medroxyprogesterone Acetate; D008525:Medroxyprogesterone; C024319:norethindrone enanthate; D009640:Norethindrone; D006854:Hydrocortisone