可以注射的避孕药存储medroxyprogesterone acetate和norethisterone enanthate实质性和差异性地降低丸激素和性激素结合型球蛋白水平:来自WHICH随机临床试验的二次研究
Chanel Avenant1, Mandisa Singata-Madliki2, Alexis J Bick1
1Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa.
PloS one
|August 23, 2024
概括
肌肉内注射的德波-麦德洛西孕酸 (DMPA-IM) 和诺乙乙酸 (NET-EN) 注射避孕药可显著降低和SHBG水平. 这些荷尔蒙变化并不能解释使用这些避孕药的女性的性行为或功能.
科学领域:
- 内分泌学 在内分泌学.
- 生殖健康 生殖健康
- 预防艾滋病毒 预防艾滋病毒
背景情况:
- 可注射的仅含孕激素的避孕药,如DMPA-IM和NET-EN在全球范围内广泛使用.
- 人们担心它们对性行为和艾滋病毒感染风险的潜在影响,可能是由于荷尔蒙变化造成的.
- 之前的研究表明,与DMPA-IM相比,NET-EN的HIV感染风险较低.
研究的目的:
- 研究DMPA-IM和NET-EN对HIV阴性女性血清丸激素和性激素结合环球蛋白 (SHBG) 水平的影响.
- 确定这些激素的观察到的变化是否与性行为或性功能相关.
- 探索内源性和SHBG在避孕药诱导的荷尔蒙变化的背景下的作用.
主要方法:
- 一个开放的随机临床试验 (WHICH研究) 涉及18-40岁的HIV阴性女性.
- 参与者接受了DMPA-IM (150毫克,12周一次) 或NET-EN (200毫克,8周一次).
- 血清丸激素和SHBG水平分别在基线和启动后25周使用UHPLC-MS/MS和免疫试验进行测量.
主要成果:
- 无论是DMPA-IM还是NET-EN都显著降低了总,SHBG和计算的自由水平,从基线到25周.
- 与DMPA-IM (分别为-24.3%和-29.8%) 相比,NET-EN诱导 (-54.1%) 和SHBG (-65.1%) 的下降更大.
- 尽管发生了荷尔蒙变化,但没有观察到危险性行为或性功能的减少,这表明其他因素,比如孕激素本身的雄激素性质,可能会主导影响.
结论:
- DMPA-IM和NET-EN显著改变内源性和SHBG水平,NET-EN的影响更为明显.
- 观察到的荷尔蒙变化似乎无法解释这些避孕药的使用者的性行为或功能.
- DMPA (美德) 和NET的固有雄激素特性可能超过了内源性降低对脑中介性影响的影响.
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