Abstract

This population-based cross-sectional study assessed lipid and lipoprotein parameters in women using progestogen-only contraceptives or medications and in those using no hormones. Unselected women about age 40 to 42 years were invited, and the participation rate was 65.6%. A total of 30,636 women were premenopausal, not pregnant, and used either a progestogen [n = 3000, including 2463 users of a intrauterine device (IUD) with levonorgestrel 20 μg/24 h] or no sex hormones. Those using the hormone-releasing IUD reported better health and a healthier lifestyle than nonusers of hormones, while women using depot medroxyprogesterone acetate had a less healthy lifestyle. Compared with nonusers of hormones, users of a levonorgestrel IUD were more likely to have high density lipoprotein (HDL)-cholesterol concentrations ≤1.1 mmol/L (odds ratio 1.4; 95% CI 1.2–1.5), while users of oral norethisterone or lynestrenol, or depot medroxyprogesterone acetate had a doubled to tripled risk of low HDL-cholesterol concentrations. Use of the IUD with levonorgestrel was also linked with a decreased risk of high serum triglycerides and of high non-HDL-cholesterol concentrations and a total/HDL-cholesterol ratio similar to that of nonusers of hormones.

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