There has been a growing awareness of possible alterations in the trace element profiles of hormonal contraceptive users and their consequences. A study of serum copper and zinc levels in users of combined estrogen-progestogen contraceptives and in users of injectable progestogen was undertaken. Use of combined estrogen-progestogen contraceptives resulted in a significant decrease in serum zinc levels within 3 days and an increase in serum copper levels within 10 days. In users of combined estrogen-progestogen contraceptives the magnitude and time of occurrence of the decrease in zinc levels and the increase in copper levels was unaltered by chemical composition, dosage, route of administration, and duration of use beyond 3 months. With injectable progestogen (norethindrone enanthate, 20 mg/month), a significant decrease in serum zinc levels occurred within 24 hours after injection. Serum copper levels were not altered. With injectable progestogen, the type of drug, the dosage, and the duration of use beyond the 1st month had no effect on the magnitude of the decrease in serum zinc levels.
PIP: Changes in serum copper and zinc levels were evaluated in Indian (India) women classified as undernourished who use various forms of hormonal contraception, including combination formulations of 30 and 50 mcg ethinylestradiol; injectable combined dihydroprogesterone acetophenide and estradiol enanthate; intravaginal rings of combined d-norgestrel and estradiol; and progestin-only injectable formulations. Serum zinc levels decreased within 3 days and serum copper increased within 10 days in women using combination estrogen/progesterone contraceptives. These alterations were not affected by route of administration, dose levels, chemical composition of the 2 components, or duration of use beyond 3 months. Women using the progestin-only injectable formulation containing norethindrone enanthate (20 mg/month) showed a significant decrease in serum zinc levels within 24 hours of injection. Serum copper levels in progestin-only injectable users were unaltered, however. Again, the type of progestin injected, the dosage, and the duration of use beyond the first month had no effect on the magnitude of the decrease in serum zinc levels.