Metabolic effects of the continuous use of an oral contraceptive
containing ethinyl-estradiol and gestodene
R.B. Machado, P. Fabrini, E.M.C. Maia, F.G. Tachotti, D.B. Milano, A.M. Cruz
Department of Gynecology and Obstetrics, Faculty of Medicine, Jundiaí,
São Paulo, Brazil
Objective: The objective of this study was to evaluate the impact of
the continuous use of a contraceptive association containing ethinyl-estradiol
and gestodene on lipid profiles, carbohydrates and coagulation.
Methods: A total of 32 patients with a mean age of 25.0+3.7 years were
evaluated in a prospective, open, non-comparative study. Patients received the
contraceptive combination of ethinyl-estradiol 30 mcg and gestodene 75 mcg
continuously for six consecutive months. Plasma measurements of total
cholesterol, HDL, LDL, triglycerides, insulin, glucose, antithrombin-III,
fibrinogen, PAI-1, protein C and protein S were carried out before and after
treatment. Results were expressed as means and standard deviations of the
biochemical parameters evaluated at the beginning and at the end of the study.
Student’s t-test for paired samples was used in the statistical analysis, and
significance level was established at 5%.
Results: After six consecutive months of use of the contraceptive pill,
HDL levels showed a significant increase (p=0.001). No significant changes were
seen in the levels of total cholesterol, LDL or triglycerides. There was a
slight increase in plasma levels of insulin (p=0.059) and glucose measurements
remained practically unaltered. With respect to coagulation and fibrinolysis
parameters, a significant increase was registered in the levels of fibrinogen
and PAI-1 (p=0.042 and p=0.003, respectively), an increase, although not
significant, in antithrombin-III and a reduction, also not significant, in
protein C and protein S.
Conclusions: The continuous use of the combination of
ethinyl-estradiol/gestodene was associated with beneficial changes to the lipid
profile, as well as a slight increase in insulin levels, fibrinogen and PAI-1.
These results are comparable to those found with the use of the regular standard
oral contraceptive pill regimen with a 7-day pill-free interval.