gestodene and drospirenone

Combined oral contraceptive (COC) use has been associated with venous thrombosis (VT) (i.e., deep venous thrombosis and pulmonary embolism). The VT risk has been evaluated for many estrogen doses and progestagen types contained in COC but no comprehensive comparison involving commonly used COC is available.. To provide a comprehensive overview of the risk of venous thrombosis in women using different combined oral contraceptives.. Electronic databases (Pubmed, Embase, Web of Science, Cochrane, CINAHL, Academic Search Premier and ScienceDirect) were searched in 22 April 2013 for eligible studies, without language restrictions.. We selected studies including healthy women taking COC with VT as outcome.. The primary outcome of interest was a fatal or non-fatal first event of venous thrombosis with the main focus on deep venous thrombosis or pulmonary embolism. Publications with at least 10 events in total were eligible. The network meta-analysis was performed using an extension of frequentist random effects models for mixed multiple treatment comparisons. Unadjusted relative risks with 95% confidence intervals were reported.Two independent reviewers extracted data from selected studies.. 3110 publications were retrieved through a search strategy; 25 publications reporting on 26 studies were included. Incidence of venous thrombosis in non-users from two included cohorts was 0.19 and 0.37 per 1 000 person years, in line with previously reported incidences of 0,16 per 1 000 person years. Use of combined oral contraceptives increased the risk of venous thrombosis compared with non-use (relative risk 3.5, 95% confidence interval 2.9 to 4.3). The relative risk of venous thrombosis for combined oral contraceptives with 30-35 μg ethinylestradiol and gestodene, desogestrel, cyproterone acetate, or drospirenone were similar and about 50-80% higher than for combined oral contraceptives with levonorgestrel. A dose related effect of ethinylestradiol was observed for gestodene, desogestrel, and levonorgestrel, with higher doses being associated with higher thrombosis risk.. All combined oral contraceptives investigated in this analysis were associated with an increased risk of venous thrombosis. The effect size depended both on the progestogen used and the dose of ethinylestradiol. Risk of venous thrombosis for combined oral contraceptives with 30-35 μg ethinylestradiol and gestodene, desogestrel, cyproterone acetate and drospirenone were similar, and about 50-80% higher than with levonorgestrel. The combined oral contraceptive with the lowest possible dose of ethinylestradiol and good compliance should be prescribed-that is, 30 μg ethinylestradiol with levonorgestrel.

Topics: Androstenes; Contraceptives, Oral, Combined; Cyproterone; Desogestrel; Ethinyl Estradiol; Female; Humans; Levonorgestrel; Norpregnenes; Pulmonary Embolism; Randomized Controlled Trials as Topic; Venous Thrombosis

Two studies are presented here. Study 1 was aimed at evaluating whether the voice characteristics of women who use birth control pills that contain different progestins differ from the voice characteristics of a control group. Study 2 presents a meta-analysis that combined the results of Study 1 with those from 3 recent studies that compared voices of women who use and do not use birth control pills.. In Study 1, voice samples from 30 women with no history of voice training, who use pills with different progestins (drospirenone, desogestrel, gestodene), and 10 women who do not use the pill were recorded at specific time points across the menstrual cycle and were analyzed acoustically. In Study 2, results from Study 1 were analyzed jointly with results from three recent studies, which used similar methodologies.. Results of Study 1 did not reveal acoustic differences in sustained phonation of vowels across the pill groups and controls. Results of the meta-analysis performed in Study 2 indicated that pill users exhibited lower jitter and shimmer values on sustained vowels, whereas no difference of fundamental frequency was observed among women who use the pill.. These results support findings from previous studies, which suggested that no adverse effect on voice was detected among nonprofessional speakers who use new-generation monophasic birth control pills, for the measures studied. Furthermore, results of the meta-analysis suggested that some acoustic properties of the voice, which are reflected in perturbation measures in sustained vowels, may be improved among women who use the pill.

Topics: Adult; Androstenes; Case-Control Studies; Contraceptives, Oral; Contraceptives, Oral, Synthetic; Desogestrel; Female; Humans; Lynestrenol; Mineralocorticoid Receptor Antagonists; Norpregnenes; Regression Analysis; Speech Acoustics; Speech Production Measurement; Tape Recording; Voice Quality

To examine the impact of subject characteristics on efficacy as measured by the Pearl Index (PI) in clinical trials and to make study populations similar by matching.. Our analysis used US data from four large Phase III studies. We compared results from one fertility control patch study with pooled data from three studies with virtually identical design on oral hormonal contraceptives. First, we identified three characteristics that had the most impact on the PI. Second, we used these three variables and matched subjects from the patch study with those from the oral contraceptive (OC) studies. Finally, we calculated the PIs for matched and unmatched subjects from both the patch study and the OC studies.. A total of 3706 subjects were included in our analysis. The variables 'Hispanic ethnicity', 'previous pregnancy' and 'previous use of hormonal contraceptives' had the most impact on the PI. The PIs for the matched patch cohort and the matched OC cohort were 2.97 and 2.48, respectively. Those for the unmatched patch cohort and the unmatched OC cohort were 10.17 and 0.90, respectively.. Subject characteristics strongly influence the PI in clinical studies of hormonal contraceptives. In particular, Hispanic ethnicity, previous pregnancies and no previous use of hormonal contraceptives result in a higher PI.. PIs from different clinical trials cannot be meaningfully compared unless subject characteristics that have most impact on the PI are similar or are made to be similar statistically as we did here by matching.

Topics: Adult; Androstenes; Cohort Studies; Contraceptive Agents, Female; Contraceptives, Oral, Hormonal; Estradiol; Ethinyl Estradiol; Europe; Female; Humans; Intention to Treat Analysis; Matched-Pair Analysis; Nandrolone; Norpregnenes; Pregnancy; Pregnancy, Unwanted; Progestins; Risk Assessment; South America; Transdermal Patch; United States; Young Adult

This randomized study's aim was to compare the effect of four oral contraceptives (OCs) containing 30 mcg of ethinylestradiol (EE) and different progestogens [drospirenone, (DRSP), chlormadinone acetate (CMA), desogestrel (DSG), gestodene (GSD)] on biochemical and hormonal parameters of hyperandrogenism and sex hormone-binding globulin (SHBG) in women with polycystic ovary syndrome (PCOS).. Forty women with PCOS (age 16-35 years) were recruited and randomly assigned to one of four treatment groups of 10 women each, treated, respectively, with 3 mg DRSP/30 mcg EE (Yasmin, Bayer Shering), 2 mg CMA/30 mcg EE (Belara, Grunenthal), 75 mcg GSD/30 mcg EE (Minulet, Wyeth Lederle) and 150 mcg DSG/30 mcg EE (Practil 21, Organon Italia). Blood samples were obtained on day 6-8 of the control cycle and day 6-8 of the third treatment cycle for assay of the following hormones: androsteredione (A), total testosterone (T), free T, SHBG, dehydroepiandrosterone sulphate (DHEAS).. In all groups, mean concentrations of free T, total T and A dropped by 40-60%, and concentrations of DHEAS dropped by 20-50%. Formulations with DRSP and CMA caused a greater reduction of androgens and a progressive increase in serum concentrations of SHBG than those with DSG and GSD.. Clinical studies need to be performed to determine effects of these OCs upon clinical signs of hyperandrogenism.

Topics: Adolescent; Adult; Androstenedione; Androstenes; Chlormadinone Acetate; Contraceptives, Oral, Combined; Dehydroepiandrosterone Sulfate; Desogestrel; Ethinyl Estradiol; Female; Humans; Hyperandrogenism; Norpregnenes; Polycystic Ovary Syndrome; Progesterone Congeners; Sex Hormone-Binding Globulin; Statistics, Nonparametric; Testosterone; Young Adult

The aim of this study is to compare the effect of ethinyl estradiol 0.03 mg/gestodene 0.075 mg (EE/GSD) with ethinylestradiol 0.03 mg/drospirenone 3 mg (EE/DRSP) administered according to conventional 21/7 regimen on body mass index (BMI), blood pressure (BP), lipid metabolism and hemostatic parameters.. In this study, 160 healthy women were randomized to EE/GSD mg or EE/DRSP for 12 months. Mean differences in BMI, high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) levels and BP compared to baseline were assessed.. One hundred and forty-five (89%) of the women completed all 12 treatment cycles. The subjects randomly assigned into two treatment groups. Group EE/GSD (n = 71) and group EE/DRSP (n = 72). In group B, BMI values were significantly lower than baseline at the sixth cycle. DRSP/EE had more favorable effects on BP than GSD/EE with the mean systolic and diastolic BPs remaining lower in the DRSP/EE group. The difference between the two preparations was not statistically significant at the end of the study. TC levels remained similar in both groups throughout the study period. In both groups LDL-C levels decreased, triglyceride and HDL-C levels significantly increased from baseline levels. These changes result in increasing HDL-C/LDL-C ratio, demonstrating anti-atherogenic effect. Menstrual cycle patterns and the incidence of adverse events were similar between groups. The duration of withdrawal bleeding decreased during the study for both groups and was similar.. The EE/DRSP regimen provides good cycle control with reliable contraceptive efficacy and low incidence of adverse events. Compared with the EE/GSD preparation, the EE/DRSP preparation demonstrated a more favorable effect on BMI and BP with the mean BMI and mean BP remaining lower than baseline mean. The new formulation may be especially beneficial for women susceptible to body weight gain and rise in BP.

Topics: Adult; Androstenes; Blood Pressure; Body Mass Index; Contraceptives, Oral, Combined; Estrogens; Ethinyl Estradiol; Female; Humans; Lipid Metabolism; Lipids; Norpregnenes; Young Adult

Urinary glycosaminoglycans (uGAG) have protective effects against urinary tract disorders. Here we investigated whether oral hormonal contraceptives (OC) affect uGAG excretion.. Urine specimens were from young women regularly taking: ethinyl estradiol + drospirenone, n = 9; ethinyl estradiol + cyproterone acetate, n = 9; and ethinyl estradiol + gestodene, n = 7. Controls were from ten women not taking OC. Total uGAG was assayed as hexuronic acid/urinary creatinine. Sulfated uGAG species was determined by electrophoresis.. Unlike controls, total uGAG in the two halves of the menstrual cycle was similar in the OC groups. Whole cycle uGAG was higher in the OC groups (p < 0.01), especially for ethinyl estradiol + cyproterone acetate (p < 0.005). The three OC produced decreases of approximately 50% in heparan sulfate (p < 0.02) and dermatan sulfate (p < 0.02), and a approximately 100% increase in chondroitin sulfate (p < 0.004).. uGAG excretion is changed in women taking OC, and this might enhance the protective effects of these molecules against urinary tract disorders.

Topics: Adult; Androstenes; Chondroitin Sulfates; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Cyproterone Acetate; Dermatan Sulfate; Ethinyl Estradiol; Female; Glycosaminoglycans; Heparitin Sulfate; Humans; Norpregnenes

This open-label, randomized study evaluated the effect of two different oral contraceptives on body weight and composition during one cycle of treatment.. Eighty women (mean age, 24.6 years) were randomized into three groups and given one of the following contraceptive methods: ethinylestradiol 15 mug/gestodene 60 mug (EE/GST, n=25), ethinylestradiol 30 mug/drospirenone 3 mg (EE/DRS, n=29) or male condom (control group, n=26). Bioelectric impedance analysis (BIA) was carried out on the first, 10th and 21st days during the use of oral contraceptives or in the menstrual cycle (control group), and total body water (TBW), fat mass (FM) and fat-free mass (FFM) were measured.. No significant variations in TBW, FM or FFM were observed in the three groups during the cycle. Intergroup analysis showed no differences in TBW or FM; however, users of EE/GST showed a statistically significant increase in FFM compared to the control group.. The different doses of ethinylestradiol associated with gestodene or drospirenone showed no statistically significant effects on TBW or FM during one cycle of observation.

Topics: Adult; Androstenes; Body Composition; Body Water; Contraceptives, Oral; Electric Impedance; Ethinyl Estradiol; Female; Humans; Norpregnenes; Prospective Studies

Oral contraceptive is the most commonly used method of fertility control. Yasmin is a combination of a novel progestogen with anti-androgenic and anti-mineralcorticoid activities (3 mg Drospirenone (DRSP) and 30 microg ethinylestradiol (EE)). It has been shown in many clinical trials that Yasmin is an efficacious oral contraceptive, lacking undesired effects as with other oral contraceptives such as weight gain. However the effects of Yasmin on sexual desire and libido have not been intensively investigated so far. Investigate the effects of Yasmin on sexual desire, libido and changes in the free androgen index (FAI) compare to Meliane (75 microg gestodene + 20 microg ethinylestradiol).. The authors' report the results of a double blind randomized controlled study using a translated version of the Female Sexual Function Index questionnaire (FSFI) for the assessment of the sexual function. The free androgen index was calculated from measurements of testosterone and sexual hormone binding globulin.. The result shows statistically significant improvements regarding sexual desire, arousal and overall satisfaction in the Yasmin group. Additionally, an increased frequency of orgasms in the Meliane group was reported. Statistically significant differences between the two treatments regarding changes in the FSFI score and changes in the free androgen index have not been observed.. The novel oral contraceptive containing drospirenone (Yasmin) and the non-anti-androgenic progestin containing oral contraceptive (Meliane) do not show unfavorable effects on sexual response and libido.

Topics: Adult; Androgens; Androstenes; Contraceptives, Oral, Synthetic; Ethinyl Estradiol; Female; Health Surveys; Humans; Norpregnenes; Patient Satisfaction; Progesterone Congeners; Sexual Behavior; Surveys and Questionnaires; Thailand; Time Factors

To compare the effects of a new 21-day combined oral contraceptive containing 30 microg ethinyl/estradiol plus 3 mg drospirenone with a 21-day preparation containing 30 microg ethinyl/estradiol plus 75 microg gestodene on bone turnover and bone mineral density in young fertile women.. A randomized, controlled trial was conducted with healthy fertile women treated with 30 microg ethinyl/estradiol plus 3 mg drospirenone (group A; n = 24), 30 microg ethinyl/estradiol plus 75 microg gestodene (group B; n = 24) and healthy controls (group C, n = 23). At 3, 6, 9, and 12 months of the study, serum and urinary calcium, osteocalcin, urinary pyridinoline, and deoxypyridinoline were measured. At baseline and after 12 months, lumbar bone mineral density was determined by dual-energy X-ray absorptiometry.. In groups A and B, urinary pyridinoline and deoxypyridinoline at 6, 9, and 12 months were significantly reduced in comparison with basal values and group C (P < .05). Pyridinoline and deoxypyridinoline levels were lower in group A than in group B throughout the study, but not significantly. In group A serum calcium levels were significantly increased after 6 months. At 12 months, no significant difference was detected in lumbar bone mineral density values among the 3 groups and in comparison with basal values.. Both combined oral contraceptives exert a similar positive influence on bone turnover and bone-sparing effect in young postadolescent women.

Topics: Adult; Amino Acids; Androstenes; Bone Density; Bone Remodeling; Calcium; Contraceptives, Oral, Combined; Contraceptives, Oral, Synthetic; Ethinyl Estradiol; Female; Humans; Norpregnenes; Osteocalcin; Progesterone Congeners

Synthetic progestins are emerging contaminants of the aquatic environment with endocrine disrupting potential. The main aim of the present study was to investigate the effects of the synthetic progestins gestodene, and drospirenone on sex differentiation in common carp (Cyprinus carpio) by histological analysis. To gain insights into the mechanisms behind the observations from the in vivo experiment on sex differentiation, we analyzed expression of genes involved in hypothalamus-pituitary-gonad (HPG) and hypothalamus-pituitary-thyroid (HPT) axes, histology of hepatopancreas, and in vitro bioassays. Carp were continuously exposed to concentrations of 2 ng/L of single progestins (gestodene or drospirenone) or to their mixture at concentration 2 ng/L of each. The exposure started 24 h after fertilization of eggs and concluded 160 days post-hatching. Our results showed that exposure of common carp to a binary mixture of drospirenone and gestodene caused increased incidence of intersex (32%) when compared to clean water and solvent control groups (both 3%). Intersex most probably was induced by a combination of multiple modes of action of the studied substances, namely anti-gonadotropic activity, interference with androgen receptor, and potentially also with HPT axis or estrogen receptor.

Topics: Androstenes; Animals; Carps; Dose-Response Relationship, Drug; Endocrine Disruptors; Gene Expression Regulation, Developmental; Gonads; Hepatopancreas; Hypothalamus; Norpregnenes; Pituitary Gland; Sex Differentiation; Water Pollutants, Chemical

Hyperandrogenism is a condition affecting 5-10% of adolescents. The aim of this study was to evaluate the efficacy of very low dose of flutamide in the treatment of hyperandrogenism in adolescence. One hundred and fifty-eight patients, presenting severe acne and/or hirsutism, received 62.5 mg/day of flutamide + ethinylestradiol + gestodene for 18 months. The patients were subjected to assessments of hepatic enzymes levels. Thirty subjects treated with drospirenone + ethinylestradiol represented the control group. After 18 months of treatment, it was obtained a decrease of hirsutism (-39.9%), an almost recovery of acne (98% of patients) with better results of those obtained in control group. Only one case of light hypertransaminasemia was recorded, regressed spontaneously. Very low dose of flutamide was successful and safe and in the treatment of hyperandrogenism in adolescence.

Topics: Acne Vulgaris; Adolescent; Androgen Antagonists; Androstenes; Dose-Response Relationship, Drug; Drug Therapy, Combination; Ethinyl Estradiol; Female; Flutamide; Hirsutism; Humans; Hyperandrogenism; Norpregnenes; Treatment Outcome; Young Adult

Women are at higher risk of drug-induced torsade de pointes (TdP) than men. Androgens are protective. Influence of oral contraception on drug-induced TdP and QT prolongation is controversial.. To determine if the extent of sotalol-induced corrected QT (QTc) prolongation and specific T-wave morphological changes, which are biomarkers for the risk of drug-induced TdP, differ in patients according to the androgenic activity of the type of oral contraceptive (OCs) they take compared with patients who took no pills.. A cohort of 498 healthy, nonmenopausal women received 80 mg of oral sotalol, a drug with known risk of drug-induced TdP, during this study in a clinical investigation center. The participants also took either no oral contraception or received OCs with different types of progestin: levonorgestrel (which has high androgenic potency), desogestrel or gestodene (which has intermediate androgenic potency), or drospirenone (which has antiandrogenic properties). Women were enrolled from February 2008 to February 2012, and data analysis took place from September 2014 to May 2018.. Electrocardiographic changes 3 hours after sotalol administration.. A total of 137 women received levonorgestrel, 41 received desogestrel, 51 received gestodene, and 62 received drospirenone; another 207 received no OCs. Baseline QTc duration, plasma sotalol levels, and potassium levels did not significantly differ among groups. However, 3 hours after sotalol exposure, QTc prolongation was greater in women taking drospirenone (mean [SD] increase, 31.2 [12.6] milliseconds from baseline) than in women taking no OCs (mean [SD] increase, 24.6 [12.5] milliseconds; P = .005) or those taking levonorgestrel (mean [SD] increase, 24.2 [13.7] milliseconds; P = .005). The frequency of sotalol-induced T-wave alteration was higher in women taking drospirenone (n = 13 of 61 [21.0%]) than those taking levonorgestrel (n = 20 of 137 [14.6%]) or women taking no OCs (n = 24 of 207 [11.6%]; P = .01). Disproportionality analysis using the European pharmacovigilance database showed a higher reporting rate of OC-induced prolonged QT and ventricular arrhythmias in women taking drospirenone than levonorgestrel (drug-induced long QT syndrome: reporting odds ratio [ROR], 6.2 [95% CI, 1.3-30.8]; P = .01; ventricular arrhythmia: ROR, 3.3 [95% CI, 1.7-6.3]; P < .001).. Contraceptive pills are associated with variable drug-induced alterations of ventricular repolarization in healthy nonmenopausal women. Drospirenone, an antiandrogenic pill, was associated with increased sotalol-induced QTc prolongation, although absolute QTc prolongation was modest. This finding was supported by the European pharmacovigilance database, which showed a higher reporting rate of suspected OC-induced ventricular arrhythmias on drospirenone compared with levonorgestrel. More data are required on whether antiandrogenic OCs lead to clinically significant adverse events in patients taking QTc-prolonging drugs.

Topics: Administration, Oral; Adult; Androgen Antagonists; Androstenes; Cohort Studies; Contraceptive Agents, Female; Desogestrel; Europe; Female; Humans; Levonorgestrel; Logistic Models; Long QT Syndrome; Norpregnenes; Sotalol; Young Adult

Venous thromboembolism and arterial ischemic events are the main deleterious diseases associated with the use of combined hormonal contraceptives (CHC). Even though their composition has been substantially improved, the vascular risk persists with the most recent CHCs use. If the vascular risk associated with CHCs containing 50μg EE is significantly higher than with those containing less than 50μg, there is no evidence that the CHCs containing either 30 or 20μg of EE induce different venous risks. CHC containing gestodene, desogestrel, drospirenone or cyproterone acetate are associated with a higher risk of venous thrombosis compared with levonorgestrel-containing CHCs. CHC containing norgestimate are associated with similar venous thrombosis risk than CHC containing levonorgestrel. Venous thrombosis risk of non-oral routes of administration of CHC appears to be equivalent to the risk of CHC containing gestodene or desogestrel, but this result is based on a small number of epidemiological studies. Before prescribing a CHC, it is important to determine all vascular risk factors. Family history of ischemic arterial event or venous thromboembolism disease should be routinely sought before any CHC prescription. All CHCs are contraindicated in women with biological thrombophilia, in women with combined vascular risk factors, in women with first-degree family history of arterial or venous event (under age 50) as well as in women suffering of migraine with aura. Progestin-only contraceptives are not associated with vascular risk (arterial or venous) outside of medroxyprogesterone acetate. In women with higher vascular risk, progestin-only contraceptives (administered by oral, sous-cutaneous or intra-uterine routes) can be prescribed.

Topics: Androstenes; Contraceptive Agents, Female; Contraceptives, Oral, Combined; Contraceptives, Oral, Hormonal; Cyproterone Acetate; Desogestrel; Female; France; Humans; Levonorgestrel; Norpregnenes; Progestins; Risk Factors; Vascular Diseases; Venous Thromboembolism

This study aimed to evaluate the associated cardiovascular risk in Egyptian healthy consumers of different types of combined oral contraceptives pills (COCPs) via determination of lipids profiles, Castelli index I, leptin, adiponectin, and resistin concentrations as cardiovascular risk factors. In this cross-sectional study, the study groups consisted of control group that represented by 30 healthy married women who were not on any contraceptive mean or any hormonal therapy and had normal menstrual cycles, group two consisted of 30 women who were users of Levonorgesterl 0.15 mg plus Ethinylestradiol 0.03 mg as 21 days cycle, group three consisted of 30 women who were users of Gestodene 0.075 mg plus Ethinylestradiol 0.03 mg as 21 days cycle, and group four consisted of 30 women who were users of Drospirenone 3 mg plus Ethinylestradiol 0.03 mg as 21 days cycle. One-way analysis of variance followed by LSD post hoc test was used for comparison of variables. P value <0.05 was considered to be significant. The comparison of the studied groups revealed that COCPs containing levonorgestrel plus ethinylestradiol resulted in significantly lower adiponectin level, and significantly higher leptin and resistin levels with more atherogenic lipid profile presented by significantly higher LDL-C, significantly lower HDL-C concentrations, and significantly higher atherogenic index. Formulation containing ethinylestradiol combined with gestodene neither altered adipose tissue function nor showed deleterious effect on lipid panel. Formulation containing ethinylestradiol combined with drospirenone resulted in significantly higher HDL-C and adiponectin concentrations. In conclusion, the uptake of COCPs containing levonorgestrel plus ethinylestradiol is associated with high cardiovascular risk since this formulation showed significantly lower adiponectin concentration, significantly higher leptin, resistin, and atherogenic index as compared to other studied groups. By contrast, the formulations containing ethinylestradiol combined with third generation progestin gestodene or fourth generation progestin drospirenone are associated with low cardiovascular risk since they neither altered adipose tissue function nor impaired lipoprotein metabolism as experienced by their favorable effect on leptin, adiponectin, and resistin, with non-changed atherogenic index, higher HDL-C levels and lower LDL-C levels as compared to levonorgestrel plus ethinylestradiol formulation.

Topics: Adiponectin; Adipose Tissue; Adult; Androstenes; Anthropometry; Cardiovascular Diseases; Chemistry, Pharmaceutical; Cholesterol, HDL; Cholesterol, LDL; Contraceptives, Oral, Combined; Cross-Sectional Studies; Drug Combinations; Egypt; Ethinyl Estradiol; Female; Humans; Leptin; Levonorgestrel; Norpregnenes; Resistin; Risk Factors

Topics: Adolescent; Adult; Age Factors; Androstenes; Body Mass Index; Contraceptives, Oral, Combined; Data Collection; Data Interpretation, Statistical; Desogestrel; Female; Humans; Middle Aged; Norpregnenes; Progesterone Congeners; Reproducibility of Results; Risk Factors; Venous Thromboembolism; Young Adult

Estrogens in oral contraceptives (OC) may influence plasma aldosterone/plasma renin activity (ALD/PRA) and plasma aldosterone/plasma renin concentration (ALD/DRC) ratios, but the effect of progestins on these ratios has not been sufficiently studied so far.. PRA (RIA, DiaSorin), DRC and ALD (IRMA, RIA, Beckman Coulter) were measured, then ALD/PRA and ALD/DRC were calculated in 86 healthy normotensive women (aged 27.3 ± 7.5 years), 63 using progestin-containing OC: either gestodene (GTD, n=25), desogestrel (DSG, n=22) or drospirenone (DRSP, n=16). 23 OC-nonusers served as control.. Data are presented as median and lower and upper quartiles. PRA, DRC and ALD levels were higher (p<0.001) in the DRSP group [3.1 (1.5 3.8)ng/mL/h, 25.2 (9.8 30.4)ng/L and 43.7 (28.0 61.6)ng/dL, respectively], than in the DSG [1.4 (1.1 2.1)ng/mL/h, 8.3 (6.8 12.3)ng/L and 11.5 (7.2 16.6)ng/dL], GTD [1.2 (0.8 2.2)ng/mL/h, 8.0 (4.8 10.5)ng/L, and 13.4 (7.7 22.1) ng/dL] and control [1.3 (0.7 1.6) ng/mL/h, 12.2 (7.5 21.7) ng/L, and 10.0 (4.4 14.7) ng/dL] groups. Cases of falsely elevated ALD/PRA and ALD/DRC ratios [7 (11%) and 12 cases (19%) respectively] were only found in OC users but not in the control group. In the DSG and GTD groups, but not in the DRSP group falsely elevated ALD/PRA occurred less frequently than falsely elevated ALD/DRC.. In OC-users falsely elevated ALD/PRA and especially ALD/DRC are a common finding, particularly when the OC contains DSG or GTD. Therefore, for OC-users method- and progestin-type specific cut-off levels should be established.

Topics: Adult; Aldosterone; Androstenes; Contraceptives, Oral, Synthetic; Desogestrel; Ethinyl Estradiol; Female; Humans; Norpregnenes; Progestins; Renin; Renin-Angiotensin System; Young Adult

To assess the risk of venous thromboembolism from use of combined oral contraceptives according to progestogen type and oestrogen dose.. National historical registry based cohort study.. Four registries in Denmark.. Non-pregnant Danish women aged 15-49 with no history of thrombotic disease and followed from January 2001 to December 2009.. Relative and absolute risks of first time venous thromboembolism.. Within 8,010,290 women years of observation, 4307 first ever venous thromboembolic events were recorded and 4246 included, among which 2847 (67%) events were confirmed as certain. Compared with non-users of hormonal contraception, the relative risk of confirmed venous thromboembolism in users of oral contraceptives containing 30-40 µg ethinylestradiol with levonorgestrel was 2.9 (95% confidence interval 2.2 to 3.8), with desogestrel was 6.6 (5.6 to 7.8), with gestodene was 6.2 (5.6 to 7.0), and with drospirenone was 6.4 (5.4 to 7.5). With users of oral contraceptives with levonorgestrel as reference and after adjusting for length of use, the rate ratio of confirmed venous thromboembolism for users of oral contraceptives with desogestrel was 2.2 (1.7 to 3.0), with gestodene was 2.1 (1.6 to 2.8), and with drospirenone was 2.1 (1.6 to 2.8). The risk of confirmed venous thromboembolism was not increased with use of progestogen only pills or hormone releasing intrauterine devices. If oral contraceptives with desogestrel, gestodene, or drospirenone are anticipated to increase the risk of venous thromboembolism sixfold and those with levonorgestrel threefold, and the absolute risk of venous thromboembolism in current users of the former group is on average 10 per 10,000 women years, then 2000 women would need to shift from using oral contraceptives with desogestrel, gestodene, or drospirenone to those with levonorgestrel to prevent one event of venous thromboembolism in one year.. After adjustment for length of use, users of oral contraceptives with desogestrel, gestodene, or drospirenone were at least at twice the risk of venous thromboembolism compared with users of oral contraceptives with levonorgestrel.

Topics: Adolescent; Adult; Androstenes; Anticoagulants; Cohort Studies; Confounding Factors, Epidemiologic; Contraceptives, Oral; Denmark; Desogestrel; Dose-Response Relationship, Drug; Epidemiologic Methods; Female; Humans; Intrauterine Devices, Medicated; Levonorgestrel; Middle Aged; Mineralocorticoid Receptor Antagonists; Norpregnenes; Pregnancy; Time Factors; Venous Thromboembolism; Young Adult

Topics: Androstenes; Contraceptives, Oral; Cyproterone; Denmark; Desogestrel; Ethinyl Estradiol; Female; Humans; Levonorgestrel; Norpregnenes; Progestins; Registries; Risk; Venous Thromboembolism

Gestodene acidic treatment afforded a single rearrangement product, namely 13-beta-ethyl-18,19-dinorpregna-4,14,16-trien-3,20-dione 3, which was originated through HCl-catalyzed Rupe rearrangement. Drospirenone acidic treatment yielded two epimeric lactones by addition of HCl to the 6beta,7beta-cyclopropane ring, namely 7beta-(chloromethyl)-15beta,16beta-methylene-3-oxo-17beta-pregn-4-ene-21,17-carbolactone 4 and 7beta-(chloromethyl)-15beta,16beta-methylene-3-oxo-17alpha-pregn-4-ene-21,17-carbolactone 5. The structure of the compounds was assessed by spectroscopic and crystallographic methods.

Topics: Androstenes; Crystallography, X-Ray; Models, Biological; Models, Molecular; Molecular Structure; Norpregnenes; Progesterone Congeners

The purpose of this study was to analyze the vocal quality and resonance (nasality and nasalance values) during the menstrual cycle in professional voice users using oral contraceptive pills (OCPs). Although professional voice users are more sensitive and aware of their vocal quality, no changes of voice and resonance characteristics were expected because OCPs create a stable hormonal balance throughout the menstrual cycle.. The authors conducted a comparative study of 24 healthy, young professional voice users using OCPs. One assessment was performed between the 10th and 17th day of pill intake, when hormonal levels reached a steady state. The second assessment was performed during the first 3 days of menses, when no pills were taken and hormonal levels were minimized.. Subjective (perceptual evaluation of voice and nasality) and objective (aerodynamic, voice range, acoustic, Dysphonia Severity Index [DSI], nasometer) assessment techniques were used.. : The Mann-Whitney U test showed no significant difference between the perceptual evaluation of the voice and the nasality in the two assessments. The paired Student t test showed no significant difference regarding the maximum phonation time, the vocal performance, the acoustic parameters, and the DSI.. These findings indicate that OCPs do not have an impact on the objective and subjective voice and resonance parameters in young professional voice users. This information is specifically relevant to professional voice users who are more aware of vocal quality changes and ear, nose and throat specialists/voice therapists who treat professional voice users with voice problems/disorders. Further research regarding the impact of increased vocal load during the premenstrual or menstrual phase in professional voice users using OCPs should be considered.

Topics: Adult; Androstenes; Contraceptives, Oral, Synthetic; Desogestrel; Female; Humans; Levonorgestrel; Menstrual Cycle; Menstruation; Norpregnenes; Phonation; Speech Acoustics; Voice; Voice Disorders; Voice Quality

The ability of 11 steroids with varying degrees of progestogenic potency to inhibit the renal actions of aldosterone was tested in adrenalectomized, glucocorticoid-treated rats. The rats were continuously infused with an isotonic solution of low sodium content (0.05% NaCl + 5.2% glucose, 3 ml/rat/h) supplemented with d-aldosterone [1 microgram/(kg X h)] resulting in a long-lasting reduction in renal sodium excretion, increase in renal potassium excretion and hence decrease in the urinary Na/K-ratio. The test drugs were administered either subcutaneously or orally 1 h before start of infusion. Their antimineralocorticoid activity was judged by the increase in the aldosterone-lowered Na/K-ratio in urine which was collected at hourly intervals for 15 or 21 h, respectively. Adrenalectomized, glucocorticoid-treated rats receiving an i.v. infusion without aldosterone were used for assessing possible mineralocorticoid effects of the steroids tested. D-Norgestrel, norethisterone acetate, 3-keto-desogestrel (the active metabolite of desogestrel) and cyproterone acetate, respectively, did neither show antimineralocorticoid nor mineralocorticoid activity when injected subcutaneously at a dose of 53.3 mg/kg. In contrast, gestodene (26.7 or 53.3 mg/kg s.c., respectively), progesterone (53.3 mg/kg s.c.), spironolactone (26.7 mg/kg s.c.), spirorenone (13.3 mg/kg s.c.), 1,2-dihydro-spirorenone (13.3 mg/kg s.c.), or 1,2 alpha-methylene-spirorenone (13.3 mg/kg s.c.) exhibited significant anti-mineralocorticoid activity. Canrenone (53.3 mg/kg s.c.) slightly increased the urinary Na/K-ratio. This effect, however, was not significant. Gestodene, like spironolactone or progesterone, was devoid of aldosterone-like mineralocorticoid activity. With the exception of progesterone, the antimineralocorticoid activity of the steroids tested could also be demonstrated after oral administration. Based on the Na/K-ratio or the log (Na X 100)/K-ratio, the potency of each test compound relative to spironolactone was evaluated using regression analysis. The following results (average relative potency, spironolactone = 1.0) were obtained: gestodene: approximately 0.2; canrenone: approximately 0.3-0.35; spirorenone: approximately 7-8; 1,2-dihydro-spirorenone: approximately 8; 1,2 alpha-methylene-spirorenone: approximately 3.5. Progesterone which was evaluated after s.c. injection exhibited an average relative potency of approximately 0.35. Due to these results, gestodene may be regarded as th

Topics: Adrenalectomy; Aldosterone; Androstadienes; Androstenes; Animals; Canrenoic Acid; Canrenone; Cyproterone; Dose-Response Relationship, Drug; Male; Mineralocorticoid Receptor Antagonists; Mineralocorticoids; Norethindrone; Norgestrel; Norpregnenes; Potassium; Progesterone; Progesterone Congeners; Rats; Rats, Inbred Strains; Sodium; Spironolactone