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Metabolic profile of a continuous versus a cyclic low-dose combined oral contraceptive after one year of use.

Author(s): Rad M, Kluft C, de Kam ML, Meijer P, Cohen AF, Grubb GS, Constantine GD, Burggraaf J

Affiliation(s): Centre for Human Drug Research, Leiden, The Netherlands.

Publication date & source: 2011-04, Eur J Contracept Reprod Health Care., 16(2):85-94.

Publication type: Multicenter Study; Randomized Controlled Trial

OBJECTIVES: To compare the effects of a combined oral contraceptive (COC) taken continuously with those of one of similar composition taken cyclically on 30 variables related to haemostasis, lipids, carbohydrates, bone metabolism, and sex hormone-binding globulin (SHBG). METHODS: Randomised, open-label, multicentre, comparative substudy of a larger phase 3 trial involving 147 healthy women (age 18-49 years). Participants received the COC either continuously (levonorgestrel [LNG] 90 mug/ethinylestradiol [EE] 20 mug) or cyclically (21/7 days pattern; LNG 100 mug/EE 20 mug). RESULTS: After 13 pill packs, changes in total cholesterol (+0.23 vs. -0.06 mmol/l), low-density lipoprotein cholesterol (+0.25 vs. -0.12 mmol/l), and high-density lipoprotein cholesterol(3) (-0.06 vs. -0.15 mmol/l) differed significantly (p<0.05) between the continuous and cyclic regimens, respectively. Increases were significantly greater (p <0.05) for protein C antigen (+11.8% vs. +6.1%) and SHBG (+791 vs. +565 nmol/l), and significantly smaller (p <0.05, ranks) for D-dimer (+19 vs. +37 mug FE/l). CONCLUSIONS: Overall, the continuous and cyclic regimens affected metabolic variables similarly. The larger increase in SHBG with the continuous COC is consistent with a higher net oestrogenic effect due to a lower daily dose of LNG. Prospective studies are required to determine the long-term effects of this continuous COC regimen.

Page last updated: 2011-12-09

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