HEMOSTATIC AND METABOLIC EFFECTS OF LOWERING THE ETHINYL-ESTRADIOL DOSE FROM 30 MCG TO 20 MCG IN ORAL-CONTRACEPTIVES CONTAINING DESOGESTREL

The metabolic and hemostatic effects of two oral contraceptives contai ning 150 mcg desogestrel and 20 mcg ethinyl-estradiol (EE) (MERCILON) or 30 mcg EE (MARVELON) were compared in order to examine the effect o f reducing the EE dose in contraceptive pills. Forty-nine women partic ipated in this randomized study during 6 cycles. In both groups, there was a significant increase in triglycerides, HDL-cholesterol and apop rotein Al; the same increase was observed for SBP and CBG. Slight and transient variations of fasting blood glucose levels were seen in the 30 mcg EE group and in the two groups for fasting insulin levels. The increase in renin substrate was significantly higher with the 30 mcg E E than with the 20 mcg EE pill, In both groups, plasminogen increased significantly, but antithrombin III, total and free protein S and fibr inogen decreased significantly only in women taking the 30 mcg EE pill , whereas there was no significant change in the 20 mcg EE group. Redu cing the dose of EE in oral contraceptives from 30 mcg to 20 mcg minim izes their impact on renin substrate and hemostatic parameters.