Association of Different Formulation with Oral Contraceptive Agents in Lipid and Carbohydrates Metabolism in Women

Oral Contraceptive Agents in Lipid and Carbohydrates Metabolism in Women

Abstract

Oral contraceptives impact lipid and carbohydrate metabolism differently based on formulation. Objectives: To assess the association between Ethinylestradiol-Levonorgestrel, Ethinylestradiol-Norgestimate, and Progestin-Only contraceptives and key metabolic markers, including lipid profile and carbohydrate metabolism, in women using these formulations. Methods: A cross-sectional study recruited women aged 18–45 using one of these contraceptives for at least 6 months. Exclusion criteria included metabolic disorders, cardiovascular disease, and recent medication use affecting metabolism. Demographic and health data (BMI, blood pressure, waist-to-hip ratio) were collected. Metabolic markers—including cholesterol, LDL, HDL, triglycerides, Apolipoproteins A1/B, fasting glucose, fasting insulin, HOMA-IR, OGTT, and HbA1c were measured. Statistical tests included One-Way ANOVA, Kruskal-Wallis, and Tukey’s post-hoc (p<0.05). Results: Significant metabolic differences were observed. Ethinylestradiol-Levonorgestrel users had higher total cholesterol (p=0.002) and increased insulin resistance (HOMA-IR, p=0.019), suggesting a potential long-term cardiovascular risk. Ethinylestradiol-Norgestimate users exhibited higher Apo-lipoprotein A1 levels (p=0.005), indicating a possible cardio-protective effect in reducing atherosclerosis risk. HOMA-IR was also higher in Progestin-Only users compared to Ethinylestradiol-Norgestimate (p=0.006). No significant differences were found in fasting glucose or HbA1c. Conclusions: It was concluded that Ethinylestradiol-Norgestimate may have a more favourable metabolic profile, with lower cholesterol and insulin resistance. Tailored contraceptive selection could reduce metabolic risks, particularly in women with cardiovascular concerns. Further research is needed to assess long-term effects. However, the exclusion of women with pre-existing metabolic disorders limits the generalizability of these findings. Future studies should include these subgroups to provide a broader understanding of metabolic responses to oral contraceptives.