Effect of oral versus transdermal steroidal contraceptives on androgenic markers

Am J Obstet Gynecol. 2005 Jun;192(6):2055-9. doi: 10.1016/j.ajog.2005.02.067.

Abstract

Objective: The purpose of this study was to compare biochemical androgen profiles in women treated with the contraceptive patch versus an oral contraceptive (OC).

Study design: Twenty-four healthy women were randomly assigned to receive 3 cycles of either the contraceptive patch (ethinyl estradiol [EE] 20 microg/d and norelgestromin 150 microg/d) or OC (EE 35 mug and norgestimate 250 microg). Blood samples were taken at baseline and end of treatment. Serum levels of sex hormone-binding globulin (SHBG), total testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS), dihydrotestosterone (DHT), and 3alpha-androstanediol glucuronide (3alpha-diol G) were quantified by immunoassay methods; free T was calculated. The paired t and Student t tests were used for statistical analysis.

Results: Nineteen women completed the study (patch, n = 10; OC, n = 9). Despite a 1.6-fold relative increase in SHBG levels with the patch versus OC (449% vs 274%, P = .03), free T decreased equally in both groups (patch 60%, P < .0001; OC 59%, P < .0001). DHEAS decreased by 26% in the patch group (P < .01) and 32% in the OC group (P < .001). 3alpha-diol G was reduced by 52% in the patch group (P < .0001) and 51% in the OC group (P < .0001). In addition, the OC was associated with significant decreases in A and DHT.

Conclusion: The contraceptive patch had an effect comparable to the OC on several key androgenic markers. Given these biochemical findings, the contraceptive patch has significant potential as a therapeutic agent for disorders of androgen excess.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Cutaneous
  • Adolescent
  • Adult
  • Androgens / blood*
  • Androstenedione / blood
  • Contraceptive Agents, Female / administration & dosage
  • Contraceptive Agents, Female / pharmacology*
  • Contraceptives, Oral, Combined / pharmacology
  • Dehydroepiandrosterone Sulfate / blood
  • Dihydrotestosterone / blood
  • Drug Combinations
  • Ethinyl Estradiol / pharmacology
  • Ethisterone / analogs & derivatives
  • Female
  • Humans
  • Norgestrel / analogs & derivatives*
  • Norgestrel / pharmacology
  • Oximes
  • Sex Hormone-Binding Globulin / drug effects
  • Testosterone / blood
  • Treatment Outcome

Substances

  • Androgens
  • Contraceptive Agents, Female
  • Contraceptives, Oral, Combined
  • Drug Combinations
  • Oximes
  • Sex Hormone-Binding Globulin
  • Dihydrotestosterone
  • Norgestrel
  • Testosterone
  • Androstenedione
  • Ethinyl Estradiol
  • Dehydroepiandrosterone Sulfate
  • norgestimate
  • Ethisterone
  • norelgestromin