Abstract
BackgroundThe contraceptive skin patch (CSP) accepted by the U.S. FDA in 2001 includes ethinylestradiol and norelgestromine, whereas the subdermal contraceptive implant (SCI) has etonogestrel and is also approved by the FDA. In Mexico, both are now widely used for contraception but their effects on Mexican population are unknown. The objective of the study was to evaluate if these treatments induce metabolic changes in a sample of indigenous and mestizo Mexican women.MethodsAn observational, prospective, longitudinal, non-randomized study of women between 18 and 35 years of age assigned to CSP or SCI. We performed several laboratory tests: clinical chemistry, lipid profile, and liver and thyroid function tests. Also, serum levels of insulin, C-peptide, IGF-1, leptin, adiponectin, and C reactive protein were assayed.ResultsSixty-two women were enrolled, 25 used CSP (0 indigenous; 25 mestizos) and 37 used SCI (18 indigenous; 19 mestizos). Clinical symptoms were relatively more frequent in the SCI group. Thirty-four contraceptive users gained weight without other clinical significant changes. After 4 months of treatment, significant changes were found in some biochemical parameters in both treatment groups. Most were clinically irrelevant. Interestingly, the percentage of users with an abnormal atherogenic index diminished from 75% to 41.6% after follow-up.ConclusionsThe CSP slightly modified the metabolic variables. Most changes were nonsignificant, whereas for SCI users changes were more evident and perhaps beneficial. Results of this attempt to evaluate the effects of contraceptives in mestizo and native-American populations show that clinical symptoms are frequent in Mexican users of CSP and SCI. Although these medications may affect some metabolic variables, these changes seem clinically irrelevant. Induction of abnormalities in other physiological pathways cannot be ruled out.
Highlights
The contraceptive skin patch (CSP) accepted by the U.S Food and Drug Administration (FDA) in 2001 includes ethinylestradiol and norelgestromine, whereas the subdermal contraceptive implant (SCI) has etonogestrel and is approved by the FDA
The main cause for study withdrawal was clinical symptomatology induced by the contraconceptive method itself
62 women completed the study protocol (Figure 1): 25 women were allocated to the CSP group while 37 corresponded to the SCI group
Summary
The contraceptive skin patch (CSP) accepted by the U.S FDA in 2001 includes ethinylestradiol and norelgestromine, whereas the subdermal contraceptive implant (SCI) has etonogestrel and is approved by the FDA. In Mexico, both are widely used for contraception but their effects on Mexican population are unknown. At the end of the 20th century, oral contraceptives were used by more than 100 million women worldwide [1]. In Mexico, 5.6% of women use oral contraceptives (1.12 million women in total) [2]. Side effects of the oral contraceptives were primarily responsible for the development of new hormonal contraceptive methods. Women may choose among several options, including the contraceptive skin patch (CSP) and the subdermal contraceptive implant (SCI)
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