Metabolic and endocrine effects of the desogestrel-containing oral contraceptive Mircette™

Abstract

OBJECTIVE: The purpose was to evaluate the metabolic effects of Mircette™ (brand of desogestrel/ethinyl estradiol and ethinyl estradiol), a low-estrogen, desogestrel-containing oral contraceptive. STUDY DESIGN: Women taking Mircette™ were evaluated to determine its effects on lipid profiles ( n = 74), carbohydrate metabolism ( n = 25), and endocrine parameters ( n = 53). RESULTS: During cycles 3 and 6 of Mircette™ treatment, changes from baseline included mean increases in serum triglycerides and very low–density lipoprotein cholesterol ranging between 50% and 60%. Smaller mean increases were observed at these time points in high-density lipoprotein cholesterol subfraction 2 (range between 17% and 25%), total cholesterol (<10%), high-density lipoprotein cholesterol (range between 10% and 15%), and high-density lipoprotein cholesterol subfraction 3 (range between 9% and 13%), with only nominal changes (<6%) in low-density lipoprotein cholesterol and lipoprotein. Patients receiving Mircette™ showed no mean changes in fasting plasma glucose or serum insulin levels but did have modest increases in glucose and insulin levels after a glucose challenge. Mircette™ treatment suppressed follicle-stimulating hormone, luteinizing hormone, 17β-estradiol, and progesterone to levels consistent with inhibition of ovulation and increased concentrations of thyroid- and cortisol-binding globulins. CONCLUSIONS: Overall, Mircette™ treatment was associated with expected effects on the pituitary-ovarian axis, triglycerides, and serum binding proteins; a modest decline in glucose tolerance; and a favorable effect on lipid profiles as a result of increases in total high-density lipoprotein cholesterol and high-density lipoprotein cholesterol subfraction 2 in the absence of changes in total cholesterol or low-density lipoprotein cholesterol. (Am J Obstet Gynecol 1998;179:S9-17.)