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Insulin sensitivity and lipid metabolism with oral contraceptives containing chlormadinone acetate or desogestrel: a

Angelo Cagnacci1, Serena Ferrari, Alessandra Tirelli

  • 1Department of Obstetrics, Gynecology and Pediatrics, Gynecology and Obstetrics Unit, University of Modena, Policlinico of Modena, Via del Pozzo 71, Modena, Italy. cagnacci@unimore.it

Contraception
|January 13, 2009
PubMed
Abstract

Insights

Oral contraceptives containing desogestrel (DSG) significantly decrease insulin sensitivity (SI), while those with chlormadinone acetate (CMA) do not. EE/CMA also improved lipid profiles, unlike EE/DSG.

Area of Science:

  • Endocrinology
  • Metabolic Health
  • Pharmacology

Background:

  • Oral contraceptives (OCs) containing 30 mcg or more of ethinylestradiol (EE) are known to reduce insulin sensitivity (SI).
  • The impact of lower EE doses and progestins with antiandrogenic properties on SI requires further investigation.

Purpose of the Study:

  • To evaluate the effects of two different combined oral contraceptives on insulin sensitivity (SI) and glucose utilization (Sg).
  • To assess the impact of ethinylestradiol (EE) combined with desogestrel (DSG) versus chlormadinone acetate (CMA) on lipid profiles.

Main Methods:

  • A randomized study involving 28 healthy young women over 6 months.
  • Participants received either 20 mcg EE/150 mcg DSG or 30 mcg EE/2 mg CMA.
  • Insulin sensitivity (SI) and glucose utilization (Sg) were measured using the minimal model method; lipid profiles were also analyzed.

Main Results:

  • Insulin sensitivity (SI) significantly decreased with ethinylestradiol/desogestrel (EE/DSG) but remained unchanged with ethinylestradiol/chlormadinone acetate (EE/CMA).
  • Glucose utilization (Sg) showed no significant changes in either group.
  • EE/CMA treatment led to significant improvements in HDL cholesterol, triglycerides, and apolipoprotein levels, indicating a favorable lipid profile.

Conclusions:

  • Desogestrel (DSG), even at low ethinylestradiol (EE) doses, impairs insulin sensitivity (SI).
  • Ethinylestradiol/chlormadinone acetate (EE/CMA) does not negatively affect SI and offers benefits for lipid metabolism.

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