An open label, comparative study of the effects of a dose-reduced oral contraceptive containing 20 μg ethinyl estradiol and 100 μg levonorgestrel on hemostatic, lipids, and carbohydrate metabolism variables

Abstract

In this open label, randomized study we compared the influence of a dose-reduced oral contraceptive containing 20 μg ethinyl estradiol (EE) and 100 μg levonorgestrel (20 EE) with a reference preparation containing 30 μg EE and 150 μg levonorgestrel (30 EE) on hemostatic, lipids, and carbohydrate metabolism variables. Data from 48 volunteers were obtained. The direction of the change (increase or decrease) in most of the hemostatic variables were similar in both treatment groups. In particular, prothrombin fragment 1 + 2 increased during treatment, reaching a median percent change of 40% in the 20 EE group and of 17% in the 30 EE group after one year. D-Dimer fibrin split products remained virtually unchanged, with no change at Cycle 13. The median HDL2 cholesterol levels decreased by 26% in the 20 EE group and by 39.8% in 30 EE group (p = 0.0045 for group difference) after one year. The median one year change for LDL cholesterol was 3.23% in the 20 EE group, compared to 25% in the 30 EE group, for VLDL 11.1% compared to 38.8%, respectively, and for total triglycerides 10.0% compared to 37.5%, respectively. The median absolute change for the area under the curve (AUC)(0–3h) for glucose at treatment Cycle 13 was 41.25 mmol/L × min in the 20 EE group and 73.50 mmol/L × min in the 30 EE group. The AUC(0–3h) insulin at treatment Cycle 13 decreased in the 20 EE group by 1635.0 pmolL × min and increased in the 30 EE group by 11797.5 pmolL × min (p = 0.0491 for group difference). Both study treatments were safe and well tolerated by the volunteers. In conclusion, the balanced one-third dose reduction in this new oral contraceptive evoked similar effects on the hemostatic variables, but favorable results for the lipid and carbohydrate profiles.