Effects of a combined oral contraceptive containing 20 mcg of ethinylestradiol and 3 mg of drospirenone on the blood pressure, renin-angiotensin-aldosterone system, insulin resistance, and androgenic profile of healthy young women

Abstract

Combined oral contraceptives (COCs) may increase the risk for cardiovascular disease depending on the ethynyl estradiol (EE) dose and the androgenicity of the progestogens. Our objective was to evaluate the impact of a COC containing 20 mcg EE + 3 mg drospirenone on blood pressure (BP), renin-angiotensin-aldosterone system, insulin resistance, and androgenic profile of healthy young women. Eighty-one healthy young women aged 30 ± 1 years (case group, n = 49, received COC; control group, n = 32, used no COC) were assessed twice, before and after the 6-month study. Statistical analysis employed the paired t-tests and expressed the data in mean and standard deviation. Results were as follows: no changes in BP or in BMI; a significant increase in aldosterone, plasma renin activity, triglycerides, and total cholesterol levels, but a non-significant increase in HDL and no significant changes in LDL levels (these parameters remained within normal ranges); a significant increase in the HOMA-IR index and a significant decrease in dehydroepiandrosterone sulfate (SDHEA), androstenedione, total testosterone, and free testosterone levels; no significant variations in the control group parameters. An oral contraceptive combination of a low EE dose and an anti-androgenic progestogen does not negatively influence the risk factors for a cardiovascular disease.

Chinese abstract

复方口服避孕药（COCs）由于含有不同的炔雌醇（EE）剂量和具有雄激素作用的孕激素而可能增加心血管疾病的风险。本研究的目的在于评估含20 mcg EE + 3mg屈螺酮的COC对健康年轻女性的血压（BP），肾素-血管紧张素-醛固酮系统，胰岛素抵抗的影响。81名年龄为30±1岁的健康年轻女性（实验组，n=49，给予COC；对照组，n=32，不使用COC）在实验前和6个月实验后分别评估两次。数据分析采用配对t检验，数据用均数±标准差表示。结果如下：BP或BMI无改变；醛固酮、血浆肾素活性、甘油三酯和总胆固醇水平显著增加，但HDL不显著增加和LDL水平无显著改变（这些参数仍在正常范围内）；HOMA-IR指数显著增加，脱氢表雄酮硫酸盐(SDHEA)、雄烯二酮、总睾酮和游离睾酮显著降低；对照组参数无明显改变。含低剂量EE和抗雄作用的孕激素的复方口服避孕药不对心血管疾病的风险产生负面影响。

• Blood pressure
• drospirenone
• lipids
• oral contraceptive
• metabolism

Declaration of interest

The authors report no conflicts of interest.