Subclinical cardiovascular disease parameters after one year in new users of depot medroxyprogesterone acetate compared to copper-IUD

Eur J Contracept Reprod Health Care. 2018 Jun;23(3):201-206. doi: 10.1080/13625187.2018.1455087. Epub 2018 Apr 19.

Abstract

Purpose: To evaluate markers of cardiovascular disease in women with normal insulin sensitivity who had recently initiated use of depot medroxyprogesterone acetate (DMPA) as a contraceptive.

Materials and methods: A prospective, non-randomised, comparative study. Data of 30 women of 18-40 years of age, with normal hyperinsulinaemic-euglycaemic clamp at baseline and body mass index (BMI) < 30, who opted to use DMPA or a copper intrauterine device (IUD) as a contraceptive, were analysed. Serum samples were collected for evaluation of the lipid and hepatic profile, C-reactive protein, TNF-α, interleukin-6, leptin/adiponectin ratio and free fatty acids; body composition was evaluated using DXA, blood pressure and carotid intima-media thickness were measured. Evaluations were performed at baseline and 12 months later. The groups were compared using repeated measures analysis of variance (ANOVA). Significance level was 5%.

Results: The mean age of the women in the DMPA and IUD group was 28.7 ± 6.5 and 28.3 ± 5.8 years, respectively; the BMI was 23.0 ± 3.4 and 24.3 ± 2.7 kg/m2, respectively, in the same groups. At 12 months, triglyceride levels were higher in the DMPA group compared to the IUD group and there was an increase in apolipoprotein B-100 in relation to baseline in DMPA group; there were no other difference between the groups.

Conclusions: No clinical cardiovascular effect was found but deterioration in CV markers was observed in the first year of use of DMPA.

Keywords: Contraception; cardiovascular disease; depot-medroxyprogesterone acetate; lipid metabolism.

Publication types

  • Comparative Study

MeSH terms

  • Adiponectin / blood
  • Adolescent
  • Adult
  • Body Composition
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / epidemiology*
  • Carotid Intima-Media Thickness
  • Contraceptive Agents, Female / pharmacology*
  • Female
  • Humans
  • Interleukin-6 / blood
  • Intrauterine Devices, Copper*
  • Leptin / blood
  • Lipids / blood
  • Liver Function Tests
  • Medroxyprogesterone Acetate / pharmacology*
  • Prospective Studies
  • Tumor Necrosis Factor-alpha / blood
  • Young Adult

Substances

  • Adiponectin
  • Contraceptive Agents, Female
  • Interleukin-6
  • Leptin
  • Lipids
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein
  • Medroxyprogesterone Acetate