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

Eur J Contracept Reprod Health Care. 2011 Apr;16(2):85-94. doi: 10.3109/13625187.2011.556761.


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 μg/ethinylestradiol [EE] 20 μg) or cyclically (21/7 days pattern; LNG 100 μg/EE 20 μg).

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 μg 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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bone Remodeling / drug effects*
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Contraceptives, Oral, Combined / administration & dosage*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Ethinyl Estradiol / administration & dosage*
  • Female
  • Humans
  • Levonorgestrel / administration & dosage*
  • Lipids / blood*
  • Middle Aged
  • Sex Hormone-Binding Globulin / drug effects*
  • Triglycerides / blood
  • Women's Health
  • Young Adult


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Contraceptives, Oral, Combined
  • Lipids
  • Sex Hormone-Binding Globulin
  • Triglycerides
  • Ethinyl Estradiol
  • Levonorgestrel
  • Cholesterol