The effects of two monophasic oral contraceptives containing 30 mcg of ethinyl estradiol and either 2 mg of chlormadinone acetate or 0.15 mg of desogestrel on lipid, hormone and metabolic parameters.
BACKGROUND
This study was conducted to compare the effects of two monophasic oral contraceptives (OCs) containing ethinyl estradiol (EE) 30 mcg+either chlormadinone acetate (CMA) 2 mg (Belara) or 0.15 mg desogestrel (Marvelon) on lipid, hormone and other relevant metabolic parameters.


METHODS
Markers of lipid and carbohydrate metabolism, and reproductive hormone levels, were measured in 45 subjects randomly assigned to 6 months of treatment with one of the two OCs. The cortisol response to adrenocorticotrophic hormone (ACTH) stimulation was also evaluated.


RESULTS
In both treatment groups, triglycerides, high-density lipoprotein cholesterol (HDL-C), apolipoprotein (Apo) AI and Apo AII levels increased; low-density lipoprotein cholesterol (LDL-C) and the LDL-C/HDL-C ratio decreased; and total cholesterol and lipoprotein(a) were unchanged during treatment. Effects on HDL-C, Apo AI, LDL-C and the LDL-C/HDL-C ratio were more evident in the EE 30 mcg+CMA 2 mg group. Follicle-stimulating hormone, luteinizing hormone and androgen levels decreased and sex hormone-binding globulin levels increased in both groups. Both OCs increased basal cortisol levels and cortisol response to ACTH. Oral contraceptive did not have a clinically significant impact on carbohydrate metabolism.


CONCLUSIONS
Both low-dose monophasic OCs had comparable effects on lipid, hormone and metabolic parameters during six cycles of treatment in healthy female subjects. There was some evidence of a beneficial effect on atherogenic cardiovascular risk markers, which was slightly more pronounced with EE 30 mcg+CMA 2 mg.
Winkler
Ulrich H
UH
Department of Gynaecology and Obstetrics, Clinic of Wetzlar-Braunfels, 35578 Wetzlar, Germany. ulrich.winkler@klinikum-wetzlar-braunfe.de
Sudik
Roland
R
D000293:Adolescent; D000328:Adult; D001053:Apolipoproteins / Q000032:analysis; D050260:Carbohydrate Metabolism / Q000187:drug effects*; D002715:Chlormadinone Acetate / Q000031:analogs & derivatives / Q000494:pharmacology; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003277:Contraceptives, Oral, Combined / Q000494:pharmacology*; D003278:Contraceptives, Oral, Hormonal; D017135:Desogestrel / Q000494:pharmacology; D004997:Ethinyl Estradiol / Q000494:pharmacology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D050356:Lipid Metabolism / Q000187:drug effects*; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood; D010743:Phospholipids / Q000097:blood; D016037:Single-Blind Method; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D008055:Lipids; D008074:Lipoproteins; D010743:Phospholipids; D014280:Triglycerides; D002715:Chlormadinone Acetate; C059236:chlormadinol acetate; D004997:Ethinyl Estradiol; D017135:Desogestrel; D002784:Cholesterol; D006854:Hydrocortisone