title: Increased impact of a contraceptive vaginal ring with ethinyl estradiol and nestorone on C-reactive protein.
abstract: OBJECTIVE & STUDY DESIGN: In a parallel design, 23 and 22 healthy pre-menopausal women were randomly administered a contraceptive vaginal ring (CVR) delivering 150/15 μg Nestorone®/ethinyl estradiol (EE) daily or an oral contraceptive (OC) containing levonorgestrel and EE (150/30 μg) for three cycles, to compare the effects on C-reactive protein and other markers of inflammation. ANCOVA was performed with baseline values as covariate.
  
  
  RESULTS
  The CVR caused [estimate of difference (95% CI), 109% (16-275%)] higher levels of CRP than the OC, while no difference was observed for leukocyte 1% (-13/+17%) and monocyte counts 6% (-9/+23%). The greater increase in CRP was confined to CVR recipients exhibiting low pre-treatment CRP-levels, whereas no difference was observed in the increases for recipients in the highest tertile of pre-treatment CRP levels.
  
  
  CONCLUSIONS
  The difference in CRP rise in CVR and OC users does not correspond with the effects on other markers of inflammation and is most likely due to a specific difference in the effect of ethinyl-estradiol combined with nestorone in cases with low CRP.
authors.affiliation: Centre for Human Drug Research, Zernikedreef 10, 2333 CL, Leiden, The Netherlands. MRad@CHDR.nl
authors.forename: Mandana
authors.initials: M
authors.lastname: Rad
authors.forename: Jacobus
authors.initials: J
authors.lastname: Burggraaf
authors.forename: Regine L
authors.initials: RL
authors.lastname: Sitruk-Ware
authors.forename: Marieke L
authors.initials: ML
authors.lastname: de Kam
authors.forename: Adam F
authors.initials: AF
authors.lastname: Cohen
authors.forename: Cornelis
authors.initials: C
authors.lastname: Kluft
mesh_terms: D000293:Adolescent; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D003274:Contraceptive Devices, Female / Q000009:adverse effects*; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009653:Norprogesterones / Q000008:administration & dosage / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D009653:Norprogesterones; D004997:Ethinyl Estradiol; C029167:ST 1435; D002097:C-Reactive Protein