Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol in comparison to one containing levonorgestrel and ethinylestradiol on markers of endocrine function

Eur J Contracept Reprod Health Care. 2011 Dec;16(6):458-67. doi: 10.3109/13625187.2011.614363. Epub 2011 Sep 26.


Objectives: To compare the effects of two monophasic combined oral contraceptives, containing either nomegestrol acetate/17β-oestradiol (NOMAC/E2) or levonorgestrel/ ethinylestradiol (LNG/EE) on endocrine function, androgens, and sex hormone-binding globulin (SHBG).

Methods: Randomised, open-label, multi-centre trial involving 121 healthy women, aged 18-50 years old. Participants received NOMAC/E2 (2.5 mg/1.5 mg) in a 24/4-day regimen (n=60) or LNG/EE (150 μg/30 μg) in a 21/7-day regimen (n=61) for six cycles. The primary outcome was the change from baseline to cycle 6 in markers of adrenal and thyroid function, androgens, and SHBG.

Results: Total cortisol, corticosteroid-binding globulin (CBG), and thyroxine-binding globulin (TBG) increased from baseline in both groups, with significantly greater increases in the LNG/EE group. No relevant changes from baseline or differences between the groups were observed for thyroid-stimulating hormone (TSH) and free thyroxine (T4). Androgens and androgen precursors decreased from baseline in both groups, with significantly greater decreases in the LNG/EE group (except for free testosterone). A greater increase in SHBG was observed with NOMAC/E2 than with LNG/EE.

Conclusions: NOMAC/E2 has significantly less influence on markers of adrenal and thyroid function and androgens than LNG/EE. The clinical relevance of these findings requires further study.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Contraceptives, Oral, Combined / pharmacology*
  • Contraceptives, Oral, Synthetic / pharmacology
  • Estradiol / pharmacology*
  • Estrogens / pharmacology
  • Ethinyl Estradiol / pharmacology*
  • Female
  • Humans
  • Hydrocortisone / blood
  • Levonorgestrel / pharmacology*
  • Megestrol / pharmacology*
  • Middle Aged
  • Norpregnadienes / pharmacology*
  • Sex Hormone-Binding Globulin / metabolism
  • Testosterone Congeners / blood
  • Thyroxine-Binding Globulin / metabolism
  • Transcortin / metabolism
  • Young Adult


  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Synthetic
  • Estrogens
  • Norpregnadienes
  • Sex Hormone-Binding Globulin
  • Testosterone Congeners
  • Thyroxine-Binding Globulin
  • Ethinyl Estradiol
  • Estradiol
  • Levonorgestrel
  • nomegestrol acetate
  • Transcortin
  • Megestrol
  • Hydrocortisone