TY - JOUR
T1 - Metabolic effects of the contraceptive skin patch and subdermal contraceptive implant in Mexican women
T2 - A prospective study
AU - Hernandez-Juarez, Jesus
AU - Garcia-Latorre, Ethel A.
AU - Moreno-Hernandez, Manuel
AU - Moran-Perez, Jose Fernando
AU - Rodriguez-Escobedo, Miguel Angel
AU - Cogque-Hernandez, Gerardo
AU - Julián-Nacer, Rubén
AU - Hernandez-Giron, Xochitl
AU - Palafox-Gomez, Rosalia
AU - Isordia-Salas, Irma
AU - Majluf-Cruz, Abraham
N1 - Funding Information:
This research was done with a grant from the Consejo Nacional de Ciencia y Tecnología (CONACyT) (SALUD-2008-C01-87138). JH-J received a grant during the period between August 2010 and June 2012 from the Instituto Politecnico Nacional. AM-C is a receipt of a grant from Fundación IMSS.
PY - 2014/4/26
Y1 - 2014/4/26
N2 - Background: The contraceptive skin patch (CSP) accepted by the U.S. FDA in 2001 includes ethinylestradiol and norelgestromine, whereas the subdermal contraceptive implant (SCI) has etonogestrel and is also approved by the FDA. In Mexico, both are now widely used for contraception but their effects on Mexican population are unknown. The objective of the study was to evaluate if these treatments induce metabolic changes in a sample of indigenous and mestizo Mexican women. Methods. An observational, prospective, longitudinal, non-randomized study of women between 18 and 35 years of age assigned to CSP or SCI. We performed several laboratory tests: clinical chemistry, lipid profile, and liver and thyroid function tests. Also, serum levels of insulin, C-peptide, IGF-1, leptin, adiponectin, and C reactive protein were assayed. Results: Sixty-two women were enrolled, 25 used CSP (0 indigenous; 25 mestizos) and 37 used SCI (18 indigenous; 19 mestizos). Clinical symptoms were relatively more frequent in the SCI group. Thirty-four contraceptive users gained weight without other clinical significant changes. After 4 months of treatment, significant changes were found in some biochemical parameters in both treatment groups. Most were clinically irrelevant. Interestingly, the percentage of users with an abnormal atherogenic index diminished from 75% to 41.6% after follow-up. Conclusions: The CSP slightly modified the metabolic variables. Most changes were nonsignificant, whereas for SCI users changes were more evident and perhaps beneficial. Results of this attempt to evaluate the effects of contraceptives in mestizo and native-American populations show that clinical symptoms are frequent in Mexican users of CSP and SCI. Although these medications may affect some metabolic variables, these changes seem clinically irrelevant. Induction of abnormalities in other physiological pathways cannot be ruled out.
AB - Background: The contraceptive skin patch (CSP) accepted by the U.S. FDA in 2001 includes ethinylestradiol and norelgestromine, whereas the subdermal contraceptive implant (SCI) has etonogestrel and is also approved by the FDA. In Mexico, both are now widely used for contraception but their effects on Mexican population are unknown. The objective of the study was to evaluate if these treatments induce metabolic changes in a sample of indigenous and mestizo Mexican women. Methods. An observational, prospective, longitudinal, non-randomized study of women between 18 and 35 years of age assigned to CSP or SCI. We performed several laboratory tests: clinical chemistry, lipid profile, and liver and thyroid function tests. Also, serum levels of insulin, C-peptide, IGF-1, leptin, adiponectin, and C reactive protein were assayed. Results: Sixty-two women were enrolled, 25 used CSP (0 indigenous; 25 mestizos) and 37 used SCI (18 indigenous; 19 mestizos). Clinical symptoms were relatively more frequent in the SCI group. Thirty-four contraceptive users gained weight without other clinical significant changes. After 4 months of treatment, significant changes were found in some biochemical parameters in both treatment groups. Most were clinically irrelevant. Interestingly, the percentage of users with an abnormal atherogenic index diminished from 75% to 41.6% after follow-up. Conclusions: The CSP slightly modified the metabolic variables. Most changes were nonsignificant, whereas for SCI users changes were more evident and perhaps beneficial. Results of this attempt to evaluate the effects of contraceptives in mestizo and native-American populations show that clinical symptoms are frequent in Mexican users of CSP and SCI. Although these medications may affect some metabolic variables, these changes seem clinically irrelevant. Induction of abnormalities in other physiological pathways cannot be ruled out.
KW - Cambios metabólicos
KW - Contracepción
KW - Contraception
KW - Contraceptive skin patch
KW - Efectos metabólicos
KW - Implante contraceptivo subdérmico
KW - Metabolic changes
KW - Metabolic effects
KW - Parche cutáneo anticonceptivo
KW - Subdermal contraceptive implant
UR - http://www.scopus.com/inward/record.url?scp=84901980379&partnerID=8YFLogxK
U2 - 10.1186/1742-4755-11-33
DO - 10.1186/1742-4755-11-33
M3 - Artículo
C2 - 24767248
SN - 1742-4755
VL - 11
JO - Reproductive Health
JF - Reproductive Health
IS - 1
M1 - 33
ER -