A comparative analysis of three methods of contraception: Effects on bloodglucose and serum lipid profiles

Background: Hormonal contraceptives are one of the major means of family pl anning, yet their use is not without side effects. In this study, we have t ried to assess some of the metabolic effects of three hormonal contraceptiv es commonly used by young females. Patients and Methods: Three hundred young, healthy, nonsmoking and normoten sive women of childbearing age who were seeking contraceptive advice were r andomly allocated to one of the three groups receiving ethinyl estradiol an d norgestrel (group 1), medroxyprogesterone acetate(group 2), and levonorge strel capsules (group 3). Levels of fasting blood glucose (FBG), total chol esterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C ), and high-density lipoprotein cholesterol (HDLC), were measured prior to the initiation of therapy and after termination of the study (6 months). Results: There was no significant difference between the three groups as fa r as the mean age, height and weight were concerned. FBG increased in all t hree groups, but the difference in the rate of increase was not statistical ly significant (P=0.29). Total cholesterol, TG and LDL-C increased, while H DLC level decreased in groups 1 and 2. These changes were, however, more pr ofound in the group 2 cases. In those receiving levonorgestrel, all lipid p arameters decreased. The amount of change for the total cholesterol and tri glyceride was quite significant (P<0.001), while the reduction in HDLC was not significantly different from the other two groups by pairwise compariso ns (Tukey-HSD procedure). The LDL-C/HDL-C ratio was found to be significant ly increased in groups 1 and 2, but it remained almost unchanged in the gro up 3 cases (P<0.001). Conclusion: Because of these favorable biochemical findings, we believe tha t levonorgestrel should be the contraceptive drug of choice for women of ch ildbearing age who are seeking a safe method of contraception.