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Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills
Abstract
Estrogen and progestins have been used by millions of women as effective combined oral contraceptives. Oral contraceptives (OCs) modify surrogate markers such as lipoproteins, insulin response to glucose, and coagulation factors, that have been associated with cardiovascular and venous risk. Ethinyl-Estradiol (EE) exerts a stronger effect that natural estradiol (E2) on hepatic metabolism. New progestins with high specificity have been designed to avoid interaction with other receptors and prevent androgenic, estrogenic or glucocorticoid related side-effects. The risks and benefits of new progestins used in contraception depend upon their molecular structure, the type and dose of associated estrogen, and the delivery route. The lower impact of E2-based combinations on metabolic surrogate markers may result in an improved safety profile, but only clinical outcomes are relevant to assess the risk. Large surveillance studies are warranted to confirm this hypothesis.
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“Estrogens have a positive effect on lipid metabolism, increasing HDL-C and decreasing LDL-C, while progestins, depending on their type and androgenicity, may counteract these positive estrogenic effects [23-25] .”
From Endocrine and metabolic effects of an oral contraceptive containing estetrol and drospirenone (2021) · cites this paper as [25]
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Metadata
- Authors
- Sitruk-Ware, R., & Nath, A.
- Affiliations
- Population Council (US)
- Corresponding author
- Sitruk-Ware, Regine
- Venue
- Best Practice & Research Clinical Endocrinology & Metabolism
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 27
- Issue
- 1
- Pages
- 13-24
- ISSN
- 1521-690X (ISSN-L)
- OpenAlex
- W2101802759
- Cited by
- 247
- References
- 79
- Citations by year
- 2026: 14 · 2025: 17 · 2024: 23 · 2023: 45 · 2022: 18 · 2021: 24 · 2020: 22 · 2019: 19 · 2018: 9 · 2017: 12 · 2016: 12 · 2015: 12 · 2014: 17 · 2013: 3
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Best Practice & Research Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- oral contraceptives, ethinyl estradiol, progestins, hepatic metabolism, lipoproteins, insulin response, coagulation factors, cardiovascular risk, venous thromboembolism, contraceptive safety
- MeSH terms
- Contraceptives, Oral, Hormonal, Estrogens, Female, Humans, Progestins
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