Open AccessOn the use of Plasma Proteins as Indicators of the Metabolic Effects of Combined Oral Contraceptives
Author(s) -
Cullberg Göran,
Dovré PerArne,
Lindstedt Göran,
Steffensen Kjeld
Publication year - 1982
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016348209155359
Subject(s) - desogestrel , levonorgestrel , endocrinology , sex hormone binding globulin , medicine , ethinylestradiol , transcortin , dihydrotestosterone , radioimmunoassay , testosterone (patch) , globulin , androgen , hormone , population , environmental health , family planning , research methodology
. Ethinylestradiol (EE, 17α‐ethynyl‐1,3,5(10)‐es‐tratriene‐3,17β‐diol) 30 μg daily, in combination with 150μg per day of desogestrel (Org 2969,17α‐ethynyl‐18‐methyl‐11‐methylene‐4‐estrene‐17β‐ol) or levonorgestrel (17α‐ethynyl‐18‐methyl‐4‐estrene‐17β‐ol‐3‐one), was administered to two groups of 10 healthy human women who had been without hormonal treatment during 3 months prior to the study. The preparations were given for three 21‐day cycles with 7‐day intervals. Blood samples were taken before treatment and at the end of the third treatment period. Serum sex‐hormone binding globulin (SHBG), ceruloplasmin, ornsomucoid, C1‐esterase inhibitor and C4 were analyzed by electroimmunoassay and transcortin was assayed as cortisol‐binding capacity. Serum testosterone was assayed by radioimmunoassay of methylenedichloride extracts using an antiserum with about 20% cross‐reactivity for dihydrotestosterone (DHT). The increases in serum ceruloplasmin and transcortin concentrations were the same in both groups (about 80% and 100‐140%, respectively), whereas no significant change was noted for the orosomucoid, C1‐esterase inhibitor or C4 concentrations. The SHBG concentration, however, increased by about 220% when EE + desogestrel was used, whereas with EE + levonorgestrel there was no significant change. For both groups there was a significant correlation between post‐ and pretreatment SHBG concentrations. The results indicate that individuals with low SHBG concentrations are at risk of developing a further reduction as a result of EE+levonorgestrel administration at the dosages used. Serum testosterone (+DHT) decreased in all women but one in each group. A decrease in testosterone/SHBG ratio was observed in both groups; the decrease was most pronounced in the EE + desogestrel group. One woman in the EE+levonorgestrel group, the only individual who exhibited signs of androgenic side effects, had low values for SHBG concentration and high for the testosterone/SHBG ratio. She was then treated with 25 μg EE and 125 μg desogestrel daily for three cycles, resulting in a threefold increase in SHBG concentration, normalization of the testosterone/SHBG ratio and disappearance of androgenic side effects. The results are discussed in relation to published information on the influence of hormones on plasma protein homeostasis.