Gabriele S Merki-Feld1, Bruno Imthurn, Burkhardt Seifert. 1. Clinic of Reproductive Endocrinology, Department of Gynaecology and Obstetrics, University Hospital, Zurich, Switzerland. gabriele.merki@usz.ch
Abstract
OBJECTIVE: Epidemiological studies on the cardiovascular risk of progestagen-only contraceptives are rare. With the present study we aimed to investigate the effect of the low-dose etonogestrel-releasing contraceptive implant Implanon on cardiovascular risk factors, including markers of inflammation. DESIGN: Longitudinal study. SETTING: Family planning centre of a University Hospital. SUBJECTS: Thirty-six healthy, nonsmoking women with regular cycles (n = 18 controls without hormonal contraception; n = 18 cases requesting the insertion of Implanon. MEASUREMENTS: Blood samples for the determination of C-reactive protein (CRP), nitric oxide (NO), sex hormones and plasma lipids were taken in the early follicular phase of the cycle in both groups. A second sample was taken 12 weeks after Implanon insertion or in the controls during the early follicular phase of cycle 4. RESULTS: Implanon treatment caused a 36% decrease in CRP (P < 0.06) and a significant decrease in high density lipoprotein (HDL) (P < 0.007), low density lipoprotein (LDL) (P < 0.001), cholesterol (P < 0.001), testosterone (P < 0.05) and SHBG (P < 0.002). Levels of NO, oestradiol and progesterone were not affected in either group. The cholesterol/HDL ratio did not change in Implanon carriers. There was a significant correlation between the cardiovascular risk factors CRP, cholesterol/HDL ratio and NO. CONCLUSION: The progestagen-only implant Implanon does not exert a negative effect on the cardiovascular risk factors CRP, cholesterol/HDL ratio and NO. These results suggest that the use of a progestagen-only contraception does not increase cardiovascular risk factors in healthy young women.
OBJECTIVE: Epidemiological studies on the cardiovascular risk of progestagen-only contraceptives are rare. With the present study we aimed to investigate the effect of the low-dose etonogestrel-releasing contraceptive implant Implanon on cardiovascular risk factors, including markers of inflammation. DESIGN: Longitudinal study. SETTING: Family planning centre of a University Hospital. SUBJECTS: Thirty-six healthy, nonsmoking women with regular cycles (n = 18 controls without hormonal contraception; n = 18 cases requesting the insertion of Implanon. MEASUREMENTS: Blood samples for the determination of C-reactive protein (CRP), nitric oxide (NO), sex hormones and plasma lipids were taken in the early follicular phase of the cycle in both groups. A second sample was taken 12 weeks after Implanon insertion or in the controls during the early follicular phase of cycle 4. RESULTS: Implanon treatment caused a 36% decrease in CRP (P < 0.06) and a significant decrease in high density lipoprotein (HDL) (P < 0.007), low density lipoprotein (LDL) (P < 0.001), cholesterol (P < 0.001), testosterone (P < 0.05) and SHBG (P < 0.002). Levels of NO, oestradiol and progesterone were not affected in either group. The cholesterol/HDL ratio did not change in Implanon carriers. There was a significant correlation between the cardiovascular risk factors CRP, cholesterol/HDL ratio and NO. CONCLUSION: The progestagen-only implant Implanon does not exert a negative effect on the cardiovascular risk factors CRP, cholesterol/HDL ratio and NO. These results suggest that the use of a progestagen-only contraception does not increase cardiovascular risk factors in healthy young women.
Authors: Jesus Hernandez-Juarez; Ethel A Garcia-Latorre; Manuel Moreno-Hernandez; Jose Fernando Moran-Perez; Miguel Angel Rodriguez-Escobedo; Gerardo Cogque-Hernandez; Rubén Julián-Nacer; Xochitl Hernandez-Giron; Rosalia Palafox-Gomez; Irma Isordia-Salas; Abraham Majluf-Cruz Journal: Reprod Health Date: 2014-04-26 Impact factor: 3.223