[Metabolic effects of oral contraceptives]

Estrogens and the progestogens of an oral contraceptive can cause metabolic effects either by themselves or in combination with each other. Those induced by progestogens seem to be of particular importance. Influences of both steroids on water und electrolyte metabolism are of little relevance, those on carbohydrate metabolism must be expected in diabetic patients and are possible in high-risk-patients, weight increase may occur. Progestogens with androgenic properties can have important effects on the synthesis of carrier proteins, such as SHBG, and produce a lipid pattern which is usually associated with atherogenesis. Estrogens are rather anti-atherogenic in this respect. Newly developed progestogens seem to lack these possibly life-threatening influences on protein and fat metabolism. Their use might enable the production of oral contraceptives with less side and after-effects.