Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial
This clinical trial aims to compare hormonal and metabolic changes after a 9-week continuous use of oral or vaginal combined hormonal contraceptives (CHCs) in women with polycystic ovary syndrome (PCOS). We recruited 24 women with PCOS and randomized them to use either combined oral (COC, <i>n...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/8/2827 |
| _version_ | 1797604942228226048 |
|---|---|
| author | Maria-Elina Mosorin Terhi Piltonen Anni S. Rantala Marika Kangasniemi Elisa Korhonen Risto Bloigu Juha S. Tapanainen Laure Morin-Papunen |
| author_facet | Maria-Elina Mosorin Terhi Piltonen Anni S. Rantala Marika Kangasniemi Elisa Korhonen Risto Bloigu Juha S. Tapanainen Laure Morin-Papunen |
| author_sort | Maria-Elina Mosorin |
| collection | DOAJ |
| description | This clinical trial aims to compare hormonal and metabolic changes after a 9-week continuous use of oral or vaginal combined hormonal contraceptives (CHCs) in women with polycystic ovary syndrome (PCOS). We recruited 24 women with PCOS and randomized them to use either combined oral (COC, <i>n</i> = 13) or vaginal (CVC, <i>n</i> = 11) contraception. At baseline and 9 weeks, blood samples were collected and a 2 h glucose tolerance test (OGTT) was performed to evaluate hormonal and metabolic outcomes. After treatment, serum sex hormone binding globulin (SHBG) levels increased (<i>p</i> < 0.001 for both groups) and the free androgen index (FAI) decreased in both study groups (COC <i>p</i> < 0.001; CVC <i>p</i> = 0.007). OGTT glucose levels at 60 min (<i>p</i> = 0.011) and AUCglucose (<i>p</i> = 0.018) increased in the CVC group. Fasting insulin levels (<i>p</i> = 0.037) increased in the COC group, and insulin levels at 120 min increased in both groups (COC <i>p</i> = 0.004; CVC <i>p</i> = 0.042). There was a significant increase in triglyceride (<i>p</i> < 0.001) and hs-CRP (<i>p</i> = 0.032) levels in the CVC group. Both oral and vaginal CHCs decreased androgenicity and tended to promote insulin resistance in PCOS women. Larger and longer studies are needed to compare the metabolic effects of different administration routes of CHCs on women with PCOS. |
| first_indexed | 2024-03-11T04:53:59Z |
| format | Article |
| id | doaj.art-5b3ccd7f071149028461757a2498dda4 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:53:59Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5b3ccd7f071149028461757a2498dda42023-11-17T19:49:02ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01128282710.3390/jcm12082827Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled TrialMaria-Elina Mosorin0Terhi Piltonen1Anni S. Rantala2Marika Kangasniemi3Elisa Korhonen4Risto Bloigu5Juha S. Tapanainen6Laure Morin-Papunen7Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, FinlandDepartment of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, FinlandDepartment of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, FinlandDepartment of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, FinlandDepartment of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, FinlandResearch Unit of Clinical Medicine, University of Oulu, 90220 Oulu, FinlandDepartment of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, 00290 Helsinki, FinlandDepartment of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, FinlandThis clinical trial aims to compare hormonal and metabolic changes after a 9-week continuous use of oral or vaginal combined hormonal contraceptives (CHCs) in women with polycystic ovary syndrome (PCOS). We recruited 24 women with PCOS and randomized them to use either combined oral (COC, <i>n</i> = 13) or vaginal (CVC, <i>n</i> = 11) contraception. At baseline and 9 weeks, blood samples were collected and a 2 h glucose tolerance test (OGTT) was performed to evaluate hormonal and metabolic outcomes. After treatment, serum sex hormone binding globulin (SHBG) levels increased (<i>p</i> < 0.001 for both groups) and the free androgen index (FAI) decreased in both study groups (COC <i>p</i> < 0.001; CVC <i>p</i> = 0.007). OGTT glucose levels at 60 min (<i>p</i> = 0.011) and AUCglucose (<i>p</i> = 0.018) increased in the CVC group. Fasting insulin levels (<i>p</i> = 0.037) increased in the COC group, and insulin levels at 120 min increased in both groups (COC <i>p</i> = 0.004; CVC <i>p</i> = 0.042). There was a significant increase in triglyceride (<i>p</i> < 0.001) and hs-CRP (<i>p</i> = 0.032) levels in the CVC group. Both oral and vaginal CHCs decreased androgenicity and tended to promote insulin resistance in PCOS women. Larger and longer studies are needed to compare the metabolic effects of different administration routes of CHCs on women with PCOS.https://www.mdpi.com/2077-0383/12/8/2827PCOSoral combined hormonal contraceptionvaginal combined hormonal contraceptionmetabolic effectsOGTT |
| spellingShingle | Maria-Elina Mosorin Terhi Piltonen Anni S. Rantala Marika Kangasniemi Elisa Korhonen Risto Bloigu Juha S. Tapanainen Laure Morin-Papunen Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial Journal of Clinical Medicine PCOS oral combined hormonal contraception vaginal combined hormonal contraception metabolic effects OGTT |
| title | Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial |
| title_full | Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial |
| title_fullStr | Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial |
| title_full_unstemmed | Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial |
| title_short | Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial |
| title_sort | oral and vaginal hormonal contraceptives induce similar unfavorable metabolic effects in women with pcos a randomized controlled trial |
| topic | PCOS oral combined hormonal contraception vaginal combined hormonal contraception metabolic effects OGTT |
| url | https://www.mdpi.com/2077-0383/12/8/2827 |
| work_keys_str_mv | AT mariaelinamosorin oralandvaginalhormonalcontraceptivesinducesimilarunfavorablemetaboliceffectsinwomenwithpcosarandomizedcontrolledtrial AT terhipiltonen oralandvaginalhormonalcontraceptivesinducesimilarunfavorablemetaboliceffectsinwomenwithpcosarandomizedcontrolledtrial AT annisrantala oralandvaginalhormonalcontraceptivesinducesimilarunfavorablemetaboliceffectsinwomenwithpcosarandomizedcontrolledtrial AT marikakangasniemi oralandvaginalhormonalcontraceptivesinducesimilarunfavorablemetaboliceffectsinwomenwithpcosarandomizedcontrolledtrial AT elisakorhonen oralandvaginalhormonalcontraceptivesinducesimilarunfavorablemetaboliceffectsinwomenwithpcosarandomizedcontrolledtrial AT ristobloigu oralandvaginalhormonalcontraceptivesinducesimilarunfavorablemetaboliceffectsinwomenwithpcosarandomizedcontrolledtrial AT juhastapanainen oralandvaginalhormonalcontraceptivesinducesimilarunfavorablemetaboliceffectsinwomenwithpcosarandomizedcontrolledtrial AT lauremorinpapunen oralandvaginalhormonalcontraceptivesinducesimilarunfavorablemetaboliceffectsinwomenwithpcosarandomizedcontrolledtrial |