Effect of oral versus transdermal steroidal contraceptives on androgenic markers.
OBJECTIVE
The purpose of this study was to compare biochemical androgen profiles in women treated with the contraceptive patch versus an oral contraceptive (OC).


METHODS
Twenty-four healthy women were randomly assigned to receive 3 cycles of either the contraceptive patch (ethinyl estradiol [EE] 20 microg/d and norelgestromin 150 microg/d) or OC (EE 35 mug and norgestimate 250 microg). Blood samples were taken at baseline and end of treatment. Serum levels of sex hormone-binding globulin (SHBG), total testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS), dihydrotestosterone (DHT), and 3alpha-androstanediol glucuronide (3alpha-diol G) were quantified by immunoassay methods; free T was calculated. The paired t and Student t tests were used for statistical analysis.


RESULTS
Nineteen women completed the study (patch, n = 10; OC, n = 9). Despite a 1.6-fold relative increase in SHBG levels with the patch versus OC (449% vs 274%, P = .03), free T decreased equally in both groups (patch 60%, P < .0001; OC 59%, P < .0001). DHEAS decreased by 26% in the patch group (P < .01) and 32% in the OC group (P < .001). 3alpha-diol G was reduced by 52% in the patch group (P < .0001) and 51% in the OC group (P < .0001). In addition, the OC was associated with significant decreases in A and DHT.


CONCLUSIONS
The contraceptive patch had an effect comparable to the OC on several key androgenic markers. Given these biochemical findings, the contraceptive patch has significant potential as a therapeutic agent for disorders of androgen excess.
White
Terry
T
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of South California Keck School of Medicine, Los Angeles, USA. terryw@wharton.upenn.edu
Jain
John K
JK
Stanczyk
Frank Z
FZ
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000494:pharmacology*; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D013196:Dihydrotestosterone / Q000097:blood; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000494:pharmacology; D005003:Ethisterone / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D009644:Norgestrel / Q000031:analogs & derivatives* / Q000494:pharmacology; D010091:Oximes; D012738:Sex Hormone-Binding Globulin / Q000187:drug effects; D013739:Testosterone / Q000097:blood; D016896:Treatment Outcome
D000728:Androgens; D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; D010091:Oximes; D012738:Sex Hormone-Binding Globulin; D013196:Dihydrotestosterone; D009644:Norgestrel; D013739:Testosterone; D000735:Androstenedione; D004997:Ethinyl Estradiol; D019314:Dehydroepiandrosterone Sulfate; C017576:norgestimate; D005003:Ethisterone; C449219:norelgestromin