Metabolic effects of the contraceptive skin patch and subdermal contraceptive implant in Mexican women: a prospective study.
BACKGROUND
The contraceptive skin patch (CSP) accepted by the U.S. FDA in 2001 includes ethinylestradiol and norelgestromine, whereas the subdermal contraceptive implant (SCI) has etonogestrel and is also approved by the FDA. In Mexico, both are now widely used for contraception but their effects on Mexican population are unknown. The objective of the study was to evaluate if these treatments induce metabolic changes in a sample of indigenous and mestizo Mexican women.


METHODS
An observational, prospective, longitudinal, non-randomized study of women between 18 and 35 years of age assigned to CSP or SCI. We performed several laboratory tests: clinical chemistry, lipid profile, and liver and thyroid function tests. Also, serum levels of insulin, C-peptide, IGF-1, leptin, adiponectin, and C reactive protein were assayed.


RESULTS
Sixty-two women were enrolled, 25 used CSP (0 indigenous; 25 mestizos) and 37 used SCI (18 indigenous; 19 mestizos). Clinical symptoms were relatively more frequent in the SCI group. Thirty-four contraceptive users gained weight without other clinical significant changes. After 4 months of treatment, significant changes were found in some biochemical parameters in both treatment groups. Most were clinically irrelevant. Interestingly, the percentage of users with an abnormal atherogenic index diminished from 75% to 41.6% after follow-up.


CONCLUSIONS
The CSP slightly modified the metabolic variables. Most changes were nonsignificant, whereas for SCI users changes were more evident and perhaps beneficial. Results of this attempt to evaluate the effects of contraceptives in mestizo and native-American populations show that clinical symptoms are frequent in Mexican users of CSP and SCI. Although these medications may affect some metabolic variables, these changes seem clinically irrelevant. Induction of abnormalities in other physiological pathways cannot be ruled out.
Jesus
J
Hernandez-Juarez
Ethel A
EA
Garcia-Latorre
Manuel
M
Moreno-Hernandez
Jose Fernando
JF
Moran-Perez
Miguel Angel
MA
Rodriguez-Escobedo
Gerardo
G
Cogque-Hernandez
Rubén
R
Julián-Nacer
Xochitl
X
Hernandez-Giron
Rosalia
R
Palafox-Gomez
Irma
I
Isordia-Salas
Unidad de Investigacion Medica en Trombosis Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico. amajlufc@gmail.com.
Abraham
A
Majluf-Cruz
D052242:Adiponectin / Q000097:blood; D000328:Adult; D002096:C-Peptide / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D017135:Desogestrel / Q000008:administration & dosage / Q000009:adverse effects*; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D020738:Leptin / Q000097:blood; D050356:Lipid Metabolism / Q000187:drug effects; D008111:Liver Function Tests; D008137:Longitudinal Studies; D008800:Mexico; D009644:Norgestrel / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D010091:Oximes / Q000008:administration & dosage / Q000009:adverse effects; D013960:Thyroid Function Tests; D057968:Transdermal Patch; D015430:Weight Gain / Q000187:drug effects
D052242:Adiponectin; D002096:C-Peptide; D003271:Contraceptive Agents, Female; D004338:Drug Combinations; D007328:Insulin; D020738:Leptin; D010091:Oximes; C044815:etonogestrel; D009644:Norgestrel; D004997:Ethinyl Estradiol; D007334:Insulin-Like Growth Factor I; D017135:Desogestrel; D002097:C-Reactive Protein; C449219:norelgestromin