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Related Experiment Videos

Contraceptive Steroids, age, and the cardiovascular system

E R Plunkett

    American Journal of Obstetrics and Gynecology
    |March 15, 1982
    PubMed
    Summary

    Oral contraceptives may increase cardiovascular risks for women over 35, particularly due to progestogen content. Lowering progestogen and estrogen doses is recommended for safer oral contraception.

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    Area of Science:

    • Reproductive endocrinology
    • Cardiovascular health
    • Pharmacology

    Background:

    • Oral contraceptives (OCs) are associated with increased cardiovascular risks in women over 35.
    • Estrogen's role in these risks has been debated, with some studies showing no increased risk in postmenopausal women on estrogen therapy.
    • Emerging data suggest progestogen dosage may be a key factor in cardiovascular complications.

    Purpose of the Study:

    • To investigate the relationship between progestogen dosage in oral contraceptives and cardiovascular risk.
    • To re-evaluate the role of estrogen versus progestogen in OC-related cardiovascular complications.
    • To determine optimal steroid dosages for oral contraception in women over 35.

    Main Methods:

    • Review of clinical data on oral contraceptive use and cardiovascular events.
    Keywords:
    Age FactorsBiologyCardiovascular EffectsContraceptionContraceptive AgentsContraceptive Agents, EstrogenContraceptive Agents, FemaleContraceptive Agents, ProgestinContraceptive Methods--side effectsDemographic FactorsFamily PlanningFemale SterilizationMenopauseMortalityOral Contraceptives--side effectsPhysiologyPopulationPopulation CharacteristicsPopulation DynamicsTreatment

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  • Analysis of the impact of different progestogen and estrogen doses on lipid profiles, specifically high-density lipoprotein (HDL) cholesterol.
  • Comparative analysis of risk in OC users versus non-users, and postmenopausal hormone therapy users.

    • Main Results:

    • Clinical data indicate a dose-dependent decrease in high-density lipoprotein cholesterol with increasing progestogen levels.
    • Evidence suggests a correlation between progestogen dosage and circulatory disease morbidity.
    • Postmenopausal women on estrogen therapy alone or with minimal progestogen did not show increased cardiovascular risk.

    Conclusions:

    • Progestogen dosage appears to be a significant factor in the cardiovascular risks associated with oral contraceptives.
    • The smallest effective doses of both estrogen and progestogen should be used in oral contraceptive formulations.
    • Particular attention to lower steroid doses is warranted for women over 35 using oral contraception.