Background: Hormonal contraceptives are one of the major means of family planning, yet their use is not without side effects. In this study, we have tried to assess some of the metabolic effects of three hormonal contraceptives commonly used by young females.
Patients and methods: Three hundred young, healthy, nonsmoking and normotensive women of childbearing age who were seeking contraceptive advice were randomly allocated to one of the three groups receiving ethinyl estradiol and norgestrel (group 1), medroxyprogesterone acetate (group 2), and levonorgestrel capsules (group 3). Levels of fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), were measured prior to the initiation of therapy and after termination of the study (6 months).
Results: There was no significant difference between the three groups as far as the mean age, height and weight were concerned. FBG increased in all three groups, but the difference in the rate of increase was not statistically significant (P=0.29). Total cholesterol, TG and LDL-C increased, while HDL-C level decreased in groups 1 and 2. These changes were, however, more profound in the group 2 cases. In those receiving levonorgestrel, all lipid parameters decreased. The amount of change for the total cholesterol and triglyceride was quite significant (P<0.001), while the reduction in HDL-C was not significantly different from the other two groups by pairwise comparisons (Tukey-HSD procedure). The LDL-C/HDL-C ratio was found to be significantly increased in groups 1 and 2, but it remained almost unchanged in the group 3 cases (P<0.001).
Conclusion: Because of these favorable biochemical findings, we believe that levonorgestrel should be the contraceptive drug of choice for women of childbearing age who are seeking a safe method of contraception.