Abstract
There are various complex interactions between combined oral contraceptives (COCs) containing the estrogen, ethinyl estradiol, and a synthetic gestagen and sex hormone binding globulin (SHBG). 1 interaction is that the magnitude of effect of the COC on hepatic synthesis, and thus serum concentration of SHBG, depends on the relative doses of the estrogen and gestagen and on the nature of the gestagen. Next, the interaction between the COC and the SHBG affects the biological activity of the synthetic steroids and influences the binding and the biological activity of the sex hormones produced by the body. The extent of this effect is based on the relative doses of the estrogen and gestagen, on the nature of the gestagen, and the concentration of endogenous sex hormones present. In addition, since women take the COC once/day, serum concentrations of the synthetic estrogen and gestagen fluctuate. Therefore the equilibrium between the synthetic hormones and the endogenous sex hormones also changes. Finally, a broad variation exists in serum concentrations of the synthetic estrogen and gestagen between females using the same COC. Therefore large intersubject variations between SHBG and the endogenous and exogenous hormones are expected.
Published Version
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