Effect of injectable and oral contraceptives on serum lipids

Abbey Berenson, Mahbubur Rahman, Gregg Wilkinson

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

OBJECTIVE: To estimate the effects of using depot medroxyprogesterone acetate (DMPA) or oral contraceptives (OCs) containing 20 micrograms ethinyl estradiol and 0.15 mg desogestrel on serum lipid levels. METHODS: Serum lipids were measured at baseline and every 6 months thereafter for 3 years in 703 white, African-American, and Hispanic women using DMPA, OC, or nonhormonal birth control. Those who discontinued DMPA were followed for up to 2 additional years. Participants completed questionnaires containing demographic and behavioral measures every 6 months and underwent 24-hour dietary recalls annually. Mixed-model regression analyses and general-estimating-equations procedures were used to estimate changes over time in lipids by method along with their predictors. RESULTS: Users of OCs experienced significantly greater increases in levels of triglycerides, total cholesterol, very-low-density lipoprotein (VLDL) cholesterol, and high-density lipoprotein (HDL) cholesterol than did nonhormonal-contraceptive users (P<.001). However, no difference was noted in the low-density lipoprotein (LDL) cholesterol:HDL ratio between OC users and nonhormonal-contraceptive users. Among DMPA users, HDL levels initially decreased for 6 months but then returned to baseline. The LDL:HDL ratio rose in the first 6 months of DMPA use but then dropped back to baseline over the next 24 months. After DMPA was discontinued, triglyceride, VLDL, and HDL levels were significantly higher in women who used OCs than in those who chose nonhormonal (P<.05) methods. CONCLUSION: Use of very-low-dose OCs containing desogestrel can elevate lipid levels. Users of DMPA were at increased risk of developing an abnormally low HDL level as well as an abnormally high LDL level and an increase in the LDL:HDL cholesterol ratio, although these effects appeared to be temporary.

Original languageEnglish (US)
Pages (from-to)786-794
Number of pages9
JournalObstetrics and Gynecology
Volume114
Issue number4
DOIs
StatePublished - 2009

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Medroxyprogesterone Acetate
Oral Contraceptives
HDL Lipoproteins
Lipids
Injections
LDL Lipoproteins
Serum
Desogestrel
Contraceptive Agents
HDL Cholesterol
VLDL Cholesterol
Ethinyl Estradiol
Contraception
Hispanic Americans
African Americans
LDL Cholesterol
Triglycerides
Cholesterol
Regression Analysis
Demography

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Effect of injectable and oral contraceptives on serum lipids. / Berenson, Abbey; Rahman, Mahbubur; Wilkinson, Gregg.

In: Obstetrics and Gynecology, Vol. 114, No. 4, 2009, p. 786-794.

Research output: Contribution to journalArticle

Berenson, Abbey ; Rahman, Mahbubur ; Wilkinson, Gregg. / Effect of injectable and oral contraceptives on serum lipids. In: Obstetrics and Gynecology. 2009 ; Vol. 114, No. 4. pp. 786-794.
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AB - OBJECTIVE: To estimate the effects of using depot medroxyprogesterone acetate (DMPA) or oral contraceptives (OCs) containing 20 micrograms ethinyl estradiol and 0.15 mg desogestrel on serum lipid levels. METHODS: Serum lipids were measured at baseline and every 6 months thereafter for 3 years in 703 white, African-American, and Hispanic women using DMPA, OC, or nonhormonal birth control. Those who discontinued DMPA were followed for up to 2 additional years. Participants completed questionnaires containing demographic and behavioral measures every 6 months and underwent 24-hour dietary recalls annually. Mixed-model regression analyses and general-estimating-equations procedures were used to estimate changes over time in lipids by method along with their predictors. RESULTS: Users of OCs experienced significantly greater increases in levels of triglycerides, total cholesterol, very-low-density lipoprotein (VLDL) cholesterol, and high-density lipoprotein (HDL) cholesterol than did nonhormonal-contraceptive users (P<.001). However, no difference was noted in the low-density lipoprotein (LDL) cholesterol:HDL ratio between OC users and nonhormonal-contraceptive users. Among DMPA users, HDL levels initially decreased for 6 months but then returned to baseline. The LDL:HDL ratio rose in the first 6 months of DMPA use but then dropped back to baseline over the next 24 months. After DMPA was discontinued, triglyceride, VLDL, and HDL levels were significantly higher in women who used OCs than in those who chose nonhormonal (P<.05) methods. CONCLUSION: Use of very-low-dose OCs containing desogestrel can elevate lipid levels. Users of DMPA were at increased risk of developing an abnormally low HDL level as well as an abnormally high LDL level and an increase in the LDL:HDL cholesterol ratio, although these effects appeared to be temporary.

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