Six-month carbohydrate metabolism studies in women using oral contraceptives containing gestodene and ethinyl estradiol

Abstract

Twenty-five women had their carbohydrate metabolism prospectively evaluated during the six months that they used a gestodene and ethinyl estradiol monophasic oral contraceptive. Serum glucose and insulin levels were measured during a 75-gram three-hour oral glucose tolerance test. At the six-month test, the three-hour glucose and the fasting and three-hour insulin values were significantly elevated. The literature on carbohydrate metabolism during gestodene oral contraceptive use is also reviewed.

PIP: The effects of combination-type oral contraceptives (OCs) (containing 75 mcg of the progestin gestodene and 30 mcg of ethinyl estradiol [EE] on carbohydrate metabolism during 6 months of use was evaluated in 25 women with a mean age of 26.1 +or- 1.1 years, parity of .7 +or- .1, and mean control weight of 143.5 +or- 6.1 pounds. An oral glucose tolerance test was performed after a 10-hour fast and a venous blood sample was taken. After drinking 75 g of glucose, repeat blood samples were drawn. After 6 cycles of OC use each subject was given another oral glucose tolerance test. The mean weight was 144.2 +or- 6.2 pounds. No complications and pregnancies occurred. The serum glucose 3-hour value was significantly elevated at the 6-month test. Also, significant increase of the fasting and 3-hour values of insulin were found. The results suggest that gestodene is capable of altering carbohydrate metabolism via its androgen receptor activity. Triphasic preparations (1650 mcg of gestodene and 680 mcg of EE) have a similar effect on carbohydrate metabolism as do monophasic pills (1575 mcg of gestodene and 630 mcg of EE) because of similar total steroid dose. OCs containing low-dose gestodene may alter carbohydrate metabolism to some extent but the longterm effects require further investigation as such new OCs have not been proved to be superior to existing formulations.