This article is more than 5 years old. Information may no longer be current.
Oral contraception improves HDL function in overweight, obesity, PCOS
Click Here to Manage Email Alerts
HDL cholesterol function may be improved with the use of oral contraceptives for 16 weeks in women with overweight or obesity and polycystic ovary syndrome.
“The use of oral hormonal contraceptives in overweight/obese women with PCOS should be combined with recommendations for intensive lifestyle modifications,” Anuja Dokras, MD, PhD, of the department of obstetrics and gynecology at Perelman School of Medicine at the University of Pennsylvania in Philadelphia, told Endocrine Today.
Dokras and colleagues evaluated data from the OWL-PCOS study on 87 women with overweight or obesity and PCOS to determine the effects of oral contraceptive pills, intensive lifestyle modification or a combination of both on HDL cholesterol function and lipoprotein particles during 16 weeks.
Participants were randomly assigned to the oral contraceptive pill group (20 µg ethynyl estradiol/1 mg norethindrone acetate; n = 33), an intensive lifestyle modification designed to produce 10% weight loss (n = 29) or a combination of both (n = 25).
The oral contraceptive group had higher HDL cholesterol efflux compared with the combined group at baseline (P = .005); no significant differences were found between the lifestyle group and the other two groups. Positive relationships existed between HDL cholesterol efflux and HDL cholesterol (P < .0001) and total HDL particles number (P < .0001) at baseline. From baseline to the 16-week visit, the mean change in HDL cholesterol efflux was 0.11 in the oral contraceptive group (P = .008), 0.04 in the lifestyle group (P = .39) and 0.06 in the combined group (P = .18).
During the 16-week period, there were decreases in mean BMI in the lifestyle group (P < .001) and combined group (P < .001) but not in the oral contraceptive group. Improvements in insulin sensitivity index were found for the lifestyle group (P < .001) and combined group (P = .03) but not the oral contraceptive group.
Both the oral contraceptive group (P < .001) and the combined group (P < .001) experienced decreases in testosterone levels. Changes in serum testosterone levels were inversely correlated with changes in HDL cholesterol efflux (P = .05).
Compared with baseline, oral contraceptive use over 16 weeks was associated with an increase in total HDL particle number (P = .04), a decrease in HDL particle size (P = .004) and an increase in the numbers of small LDL particles (P = .006) and large LDL particles (P = .002).
No significant differences were found between the lifestyle and combined groups for changes in lipoprotein particle concentrations and size.
“The use of oral hormonal contraceptives in overweight/obese women with PCOS is associated with worsening of the lipoprotein profile but improvement in cholesterol efflux capacity,” Dokras said. “Weight loss interventions combined with the use of oral hormonal contraceptives can mitigate the adverse effects on lipoproteins. To study the effects of different combinations of hormonal contraceptives and longer durations of treatment on cholesterol efflux capacity and lipoprotein profile.” – by Amber Cox
For more information:
Anuja Dokras, MD, PhD, can be reached at adokras@obgyn.upenn.edu.
Disclosure: Dokras reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
Click Here to Manage Email Alerts