title: The effect of oral contraception on cardiometabolic risk factors in women with elevated androgen levels.
abstract: BACKGROUND
  In unselected reproductive-aged women, use of combined estrogen-progestin oral contraceptive pills has been linked with an increased risk of vascular disease. The aim of this study was to investigate the effect of oral contraception on cardiometabolic risk factors in a population of women with hyperandrogenism.
  
  
  METHODS
  The study included 16 untreated women with elevated testosterone levels and 15 matched healthy women who were then treated with oral contraceptive pills containing ethinyl estradiol (30μg) and drospirenone (3mg). Plasma lipids, glucose homeostasis markers, circulating levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, as well as urinary albumin-to-creatinine ratio (UACR) were assessed at baseline and after 12 weeks of treatment.
  
  
  RESULTS
  Compared to healthy women, women with elevated androgen levels showed increased plasma levels of hsCRP, fibrinogen and homocysteine, as well as a higher value of UACR. Oral contraception reduced androgen levels only in hyperandrogenic women. In healthy women, ethinyl estradiol plus drospirenone increased plasma levels of insulin, hsCRP, fibrinogen and homocysteine, while in women with elevated androgen levels their effect was limited only to a small increase in hsCRP.
  
  
  CONCLUSIONS
  Our results suggest that a deteriorating effect of oral contraceptive pills containing ethinyl estradiol and drospirenone in hyperandrogenic women is weaker than in healthy young women and that ethinyl estradiol/drospirenone combination therapy may be safely used in the former group of patients.
authors: Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland. Electronic address: r.krysiak@interia.pl.
authors: Robert
authors: R
authors: Krysiak
authors: Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland; Department of Cardiology, Provincial Hospital, Bielsko-Biała, Poland.
authors: Małgorzata
authors: M
authors: Gilowska
authors: Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.
authors: Bogusław
authors: B
authors: Okopień
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage*; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D008659:Metabolic Diseases / Q000097:blood* / Q000188:drug therapy; D008875:Middle Aged; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy; D012307:Risk Factors; D013739:Testosterone / Q000037:antagonists & inhibitors / Q000097:blood*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000728:Androgens; D003277:Contraceptives, Oral, Combined; D013739:Testosterone
keywords: Hormones; Hyperandrogenism; Insulin resistance; Oral contraception; Polycystic ovary syndrome