Comparative assessment of the effects of subdermal levonorgestrel implant system and long acting progestogen injection method on lipid metabolism.

Abstract

In order to compare the effects of two type of long-acting progestogen contraceptive methods with subdermal levonorgestrel (LNG) implants and depot-medroxyprogesterone acetate (DMPA) injections on lipid metabolism, a clinical cohort study was performed by requiring 25 women in each group adopting either LNG implant or DMPA injection method voluntarily. After 6 months of use, serum levels of triglycerides, total cholesterol, HDL-cholesterol and LDL-cholesterol were determined and compared between the two groups of acceptors. The mean of total cholesterol in LNG implant acceptors was significantly lower than that in DMPA injection acceptors. The mean values of HDL-cholesterol in LNG implant acceptors (41.7 +/- 7.7 mg/dl) and in DMPA injection acceptors (45.0 +/- 9.0 mg/dl) were in the normal range without significant difference between the two groups. The mean value of triglycerides did not differ significantly between LNG implant acceptors (77.6 +/- 25.1 mg/dl) and DMPA injection acceptors (91.0 +/- 30.3 mg/dl). Serum concentrations of lipid fractions such as HDL-cholesterol and LDL-cholesterol in LNG implant acceptors were relatively low compared to those in DMPA injection acceptors. Since there was a comparable reduction in both total-and HDL-cholesterol levels in the LNG implant group, the ratio of total-to HDL-cholesterol, which is thought to be a factor in determining the risk of coronary artery disease, remained in the normal range (2 +/- 4.5). This suggests that the use of these two contraceptive methods with progestogens does not alter the risk of development of coronary artery disease.