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

Gynecol Endocrinol. 2015;31(11):912-5. doi: 10.3109/09513590.2015.1062860. Epub 2015 Jul 14.

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.

Keywords: Blood pressure; drospirenone; lipids; metabolism; oral contraceptive.

MeSH terms

  • Adult
  • Aldosterone / blood
  • Androstenedione / blood
  • Androstenes / pharmacology*
  • Blood Pressure / drug effects*
  • Body Mass Index
  • Case-Control Studies
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, HDL / drug effects
  • Cholesterol, LDL / blood
  • Cholesterol, LDL / drug effects
  • Contraceptives, Oral, Combined / pharmacology*
  • Dehydroepiandrosterone Sulfate / blood
  • Drug Combinations
  • Estrogens / pharmacology*
  • Ethinyl Estradiol / pharmacology*
  • Female
  • Healthy Volunteers
  • Humans
  • Insulin Resistance*
  • Mineralocorticoid Receptor Antagonists / pharmacology*
  • Renin / blood
  • Renin / drug effects
  • Renin-Angiotensin System / drug effects*
  • Testosterone / blood
  • Triglycerides / blood

Substances

  • Androstenes
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Contraceptives, Oral, Combined
  • Drug Combinations
  • Estrogens
  • Mineralocorticoid Receptor Antagonists
  • Triglycerides
  • Testosterone
  • Androstenedione
  • Ethinyl Estradiol
  • Aldosterone
  • Dehydroepiandrosterone Sulfate
  • Cholesterol
  • Renin
  • drospirenone