Current use of combined hormonal contraception is associated with glucose metabolism disorders in perimenopausal women

Eur J Endocrinol. 2020 Dec;183(6):619-626. doi: 10.1530/EJE-20-0406.

Abstract

Objective: The use of combined hormonal contraceptives (CHCs) worsens glucose tolerance, but the risk for glucose metabolism disorders remains controversial.

Design: The study is a prospective longitudinal population-based cohort study.

Methods: The study was based on a cohort population that comprised 1879 women born in 1966. At age 46, the women answered a questionnaire on contraceptive use and underwent an oral glucose tolerance test. Glucose metabolism indices were evaluated in current CHC (n = 153), progestin-only contraceptive (POC, n = 842), and non-hormonal contraceptive users (n = 884).

Results: In the entire study population, current CHC use was significantly associated with prediabetes (OR: 2.0, 95% CI: 1.3-3.2) and type 2 diabetes (OR: 3.3, 95% CI: 1.1-9.7) compared to non-hormonal contraceptive use. After 5 years of use, the prediabetes risk increased 2.2-fold (95% CI: 1.3-3.7) and type 2 diabetes risk increased 4.5-fold (95% CI: 1.5-13.5). Compared with the current POC use, current CHC use was significantly associated with prediabetes (OR: 1.9, 95% CI: 1.2-3.0). Current POC use was not associated with any glucose metabolism disorders. The results prevailed after adjusting for BMI and socioeconomic status.

Conclusions: CHC use in perimenopausal women was associated with a significantly increased risk of glucose metabolism disorders. This association should be considered in women with increased metabolic risk.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Contraceptives, Oral, Combined / adverse effects*
  • Contraceptives, Oral, Hormonal / adverse effects*
  • Diabetes Mellitus, Type 2 / chemically induced*
  • Female
  • Glucose Metabolism Disorders / chemically induced*
  • Glucose Tolerance Test
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Perimenopause
  • Prediabetic State / chemically induced*
  • Prospective Studies

Substances

  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Hormonal