title: Extended regimens of the contraceptive vaginal ring versus hormonal oral contraceptives: effects on lipid metabolism.
abstract: BACKGROUND
  Combined oral contraceptives used in an extended regimen have been studied because of their potential benefits; however, there have been few publications on extended regimens of contraceptive vaginal rings. The aim of this study was to assess the effects of these two extended regimens on the lipid metabolism of women using these contraceptive methods during 1 year.
  
  
  METHODS
  This prospective study enrolled 150 women: 75 used a vaginal contraceptive ring (11.7 mg etonogestrel and 2.7 mg ethinyl estradiol), and 75 used oral contraceptives (30 mcg ethinyl estradiol and 150 mg desogestrel). Both groups used their respective method for 84 days followed by a 7-day pause during 1 year. At baseline and every 3 months during the study period, blood was collected to assess total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides and apolipoprotein (apo) A-I and B. The analysis of variance test was used to analyze differences in the results of these exams over time.
  
  
  RESULTS
  A total of 62 vaginal ring and 61 oral contraceptive users completed the study. There were no significant differences in the discontinuation rate, mean total cholesterol and fraction levels, apo B concentration or apo A-I/apo B ratio. Vaginal ring users had significantly higher apo A-1 levels than oral contraceptive users.
  
  
  CONCLUSIONS
  Despite the vaginal route of administration, the steroids released by the ring had the same effects on the lipid metabolism and lipoprotein levels typically seen with ethinyl estradiol given either by oral or parenteral routes.
authors: Department of Obstetrics and Gynecology of São Paulo Federal University, Family Planning Clinic, São Paulo, Brazil. c.guazzelli@uol.com.br
authors: Cristina Aparecida Falbo
authors: CA
authors: Guazzelli
authors: Fernando Augusto
authors: FA
authors: Barreiros
authors: Ricardo
authors: R
authors: Barbosa
authors: Maria Regina
authors: MR
authors: Torloni
authors: Marcia
authors: M
authors: Barbieri
mesh_terms: D000293:Adolescent; D000328:Adult; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D002784:Cholesterol / Q000097:blood; D003274:Contraceptive Devices, Female; D003278:Contraceptives, Oral, Hormonal / Q000494:pharmacology* / Q000627:therapeutic use; D017135:Desogestrel / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects*; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D003278:Contraceptives, Oral, Hormonal; D014280:Triglycerides; C044815:etonogestrel; D004997:Ethinyl Estradiol; D017135:Desogestrel; D002784:Cholesterol