title: Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction.
abstract: BACKGROUND
  Oral contraceptives (OCs) have been the preferred method of birth control because of their high rate of effectiveness. OC use, however, has been associated with women's sexual health complaints and androgen insufficiency. OC use is associated with a decrease of androgen ovarian synthesis and an increase in the production of sex hormone-binding globulin (SHBG). There have been limited studies assessing SHBG values after discontinuation of OC use.
  
  
  OBJECTIVE
  To retrospectively investigate SHBG levels before and after discontinuation of OC use.
  
  
  METHODS
  Sex hormone-binding globulin values were compared at baseline, while on the OC, and well beyond the 7-day half-life of SHBG at 49-120 (mean 80) days and >120 (mean 196) days after discontinuation of OCs.
  
  
  METHODS
  A total of 124 premenopausal women with sexual health complaints for >6 months met inclusion/exclusion criteria. Three groups of women were defined: (i) "Continued-Users" (N = 62; mean age 32 years) had been on OCs for >6 months and continued taking them; (ii) "Discontinued-Users" (N = 39; mean age 33 years) had been on OCs for >6 months and discontinued them; and (iii) "Never-Users" (N = 23; mean age 36 years) had never taken OCs.
  
  
  RESULTS
  Sex hormone-binding globulin values in the "Continued-Users" were four times higher than those in the "Never-User" group (mean 157 +/- 13 nmol/L vs. 41 +/- 4 nmol/L; P < 0.0001). Despite a decrease in SHBG values after discontinuation of OC use, SHBG levels in "Discontinued-Users" remained elevated in comparison with "Never-Users" (N = 26; P < 0.0001 for >120 days).
  
  
  CONCLUSIONS
  In women with sexual dysfunction, SHBG changes in "Discontinued-Users" did not decrease to values consistent with "Never-Users." Long-term sexual, metabolic, and mental health consequences might result as a consequence of chronic SHBG elevation. Does prolonged exposure to the synthetic estrogens of OCs induce gene imprinting and increased gene expression of SHBG in the liver in some women? Prospective research is needed.
authors.affiliation: Department of Endocrinology, Boston University Medical Center, Boston, MA, USA. clandreas@msn.com
authors.forename: Claudia
authors.initials: C
authors.lastname: Panzer
authors.forename: Sarah
authors.initials: S
authors.lastname: Wise
authors.forename: Gemma
authors.initials: G
authors.lastname: Fantini
authors.forename: Dongwoo
authors.initials: D
authors.lastname: Kang
authors.forename: Ricardo
authors.initials: R
authors.lastname: Munarriz
authors.forename: Andre
authors.initials: A
authors.lastname: Guay
authors.forename: Irwin
authors.initials: I
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood* / Q000172:deficiency; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology*; D005260:Female; D006207:Half-Life; D006801:Humans; D017697:Premenopause; D012189:Retrospective Studies; D012738:Sex Hormone-Binding Globulin / Q000187:drug effects / Q000378:metabolism*; D012735:Sexual Dysfunction, Physiological / Q000097:blood*; D018709:Statistics, Nonparametric; D016387:Women's Health
chemical_list: D000728:Androgens; D003277:Contraceptives, Oral, Combined; D012738:Sex Hormone-Binding Globulin