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The metabolic impact of oral contraceptives.
Am J Obstet Gynecol. 1992 Oct; 167(4 Pt 2):1177-84.AJ

Abstract

The hormonal components of oral contraceptives exert major effects on plasma lipoprotein metabolism. Estrogens may increase production of plasma triglycerides, leading to increased levels of very low-density lipoproteins, but they may also reduce levels of cholesterol-enriched and potentially atherogenic intermediate- and low-density lipoproteins. Furthermore, estrogens increase levels of high-density lipoproteins (HDLs), particularly the HDL2 subspecies, an effect linked to reduced mortality rates from cardiovascular disease in postmenopausal women receiving hormone replacement therapy. All combination oral contraceptives in use in the United States tend to raise levels of plasma triglycerides, low-density lipoprotein, and HDL3 to varying degrees. In contrast, changes in HDL and HDL2 reflect the combined effects of estrogen dose and relative androgenicity of the progestin component. Although in general, the lipoprotein changes are greater in magnitude with higher dose oral contraceptive preparations, they can be significant in lower dose preparations as well. Oral contraceptives also affect carbohydrate metabolism, primarily through the activity of progestin. Studies have demonstrated insulin resistance, rises in plasma insulin, and relative glucose intolerance by means of curve analysis of glucose tolerance tests. These effects are far less pronounced with lower dose preparations and with formulations using the newer progestins.

Authors+Show Affiliations

Lawrence Berkeley Laboratory, University of California, Berkeley 94720.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

1415443

Citation

Krauss, R M., and R T. Burkman. "The Metabolic Impact of Oral Contraceptives." American Journal of Obstetrics and Gynecology, vol. 167, no. 4 Pt 2, 1992, pp. 1177-84.
Krauss RM, Burkman RT. The metabolic impact of oral contraceptives. Am J Obstet Gynecol. 1992;167(4 Pt 2):1177-84.
Krauss, R. M., & Burkman, R. T. (1992). The metabolic impact of oral contraceptives. American Journal of Obstetrics and Gynecology, 167(4 Pt 2), 1177-84.
Krauss RM, Burkman RT. The Metabolic Impact of Oral Contraceptives. Am J Obstet Gynecol. 1992;167(4 Pt 2):1177-84. PubMed PMID: 1415443.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The metabolic impact of oral contraceptives. AU - Krauss,R M, AU - Burkman,R T,Jr PY - 1992/10/11/pubmed PY - 2001/3/28/medline PY - 1992/10/11/entrez KW - Arterial Occlusive Diseases KW - Arteriosclerosis KW - Atherosclerosis--determinants KW - Biology KW - Carbohydrate Metabolic Effects KW - Cardiovascular Effects KW - Cholesterol KW - Contraception KW - Contraceptive Agents, Female--side effects KW - Contraceptive Agents, Progestin--side effects KW - Contraceptive Agents--side effects KW - Contraceptive Methods--side effects KW - Diabetes Mellitus KW - Diseases KW - Endocrine System KW - Estrogens KW - Examinations And Diagnoses KW - Family Planning KW - Glucose Tolerance Test KW - Hormones KW - Laboratory Examinations And Diagnoses KW - Laboratory Procedures KW - Lipid Metabolic Effects KW - Lipids KW - Metabolic Effects KW - Oral Contraceptives, Combined--side effects KW - Oral Contraceptives--side effects KW - Physiology KW - Vascular Diseases SP - 1177 EP - 84 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 167 IS - 4 Pt 2 N2 - The hormonal components of oral contraceptives exert major effects on plasma lipoprotein metabolism. Estrogens may increase production of plasma triglycerides, leading to increased levels of very low-density lipoproteins, but they may also reduce levels of cholesterol-enriched and potentially atherogenic intermediate- and low-density lipoproteins. Furthermore, estrogens increase levels of high-density lipoproteins (HDLs), particularly the HDL2 subspecies, an effect linked to reduced mortality rates from cardiovascular disease in postmenopausal women receiving hormone replacement therapy. All combination oral contraceptives in use in the United States tend to raise levels of plasma triglycerides, low-density lipoprotein, and HDL3 to varying degrees. In contrast, changes in HDL and HDL2 reflect the combined effects of estrogen dose and relative androgenicity of the progestin component. Although in general, the lipoprotein changes are greater in magnitude with higher dose oral contraceptive preparations, they can be significant in lower dose preparations as well. Oral contraceptives also affect carbohydrate metabolism, primarily through the activity of progestin. Studies have demonstrated insulin resistance, rises in plasma insulin, and relative glucose intolerance by means of curve analysis of glucose tolerance tests. These effects are far less pronounced with lower dose preparations and with formulations using the newer progestins. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/1415443/The_metabolic_impact_of_oral_contraceptives_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(12)90408-1 DB - PRIME DP - Unbound Medicine ER -