2 the same catchment area (Bronx, Borough of New York City), had similar inner-city socioeconomic background, and were healthy and not taking any antioxidant supplements. Women consuming CoQ10 or vitamin E supplementation were excluded from the study. In this cross-section study, 70 nonsmokers, healthy premenopausal women were recruited who attended GYN clinics at the Bronx-Lebanon Hospital Center, Bronx, New York. Of these 70 subjects, forty (n = 40) women who did not use hormonal contraceptive constituted the control group. Among the 30 contraceptive users: 15 took the oral pill (Triphasic OC) for a minimum period of 6 months; 5 inserted the vaginal ring (NuvaRing) from day 1–21 for a total period of 6 cycles; and 10 used the transdermal patch (Ortho Evra) for 3 consecutive weeks each month for a minimum of 6 cycles. 2.2. Patient Disposition. We studied three contraceptive delivery systems: OC, vaginal ring, and transdermal patch. The oral preparation studied was Triphasic OC containing 0.05 mg levonorgestrel + 0.03 mg EE for the ﬁrst 6 days, 0.075 mg levonorgestrel + 0.40 mg EE for the following 5 days, and 0.125 mg levonorgestrel + 0.030 mg EE for the remaining 10 days. The vaginal delivery system NuvaRing releases 0.120 mg of etonogestrel and delivers 15 mcg of EE/day. The transdermal preparation Ortho Evra contains norelgestromin 6.0 mg and 0.75 mg EE, delivering 20 mcg of EE and 150 mcg of norelgestromin per day [6, 7]. 2.3. HPLC Analysis of Serum Antioxidants. A peripheral venous blood sample (10 ml) was collected from each study subject between days 17 and 20 of the use of pill, patch, or ring during the sixth cycle. No dietary restrictions were imposed upon any of the subjects and patients were excluded if they were using any vitamin E or CoQ10 supplementation. A brief dietary questionnaire was completed by each partic- ipant. Serum was separated by centrifugation within 1-2 h after being drawn and stored at −80◦C prior to analysis for no more than 7 days. Serum levels of CoQ10, α-tocopherol, and γ-tocopherol were measured by HPLC methods, as described previously [8, 9]. The coeﬃcients of variation were <8% for all nutrients. Serum total cholesterol level was measured by the RIA method in the clinical laboratory at our institution. 2.4. Total Antioxidant Capacity Assay (TAOC). TAOC was measured colorometrically with a commercially available kit (Northwest, Vancouver, WA) on a Luminometer [10]. The assay measures the ability of total antioxidant status of the serum to prevent the formation of peroxyl free radicals generated by thermal decomposition of 2,2 -azobis (2-amidinopropane) (ABAP). These peroxyl radicals react with luminol to generate a luminol radical (LH∗) that results in emission of blue light centered at ≈425 nm. When antioxidants are present, luminescence is inhibited until the antioxidants are exhausted with the degree of suppression of color production being proportional to the antioxidant concentration of the added sample. Trolox, a water-soluble Obstetrics and Gynecology International vitamin E analogue, was used as the standard, and the results were calculated in mM Trolox equivalents (mM Trolox equivalents/L). The analytical sensitivity of this method has been found to be 0.04 mM Trolox equivalents (n = 5) for serum. The intra-assay coeﬃcient of variation was <2%. 2.5. Data Analysis. The data were expressed as means ± SD. Statistical analyses were performed using the Student t-test and ANOVA between (a) the contraceptive nonusers and users, and (b) the TAOC diﬀerent between the four groups. Diﬀerences were considered statistically signiﬁcant at P < .05. 3. Results In this preliminary study, a total of 70 non-smoker women (median age: 33 y; range: 28–44 y) were enrolled with informed consent. The majority of study subjects were Hispanics (59%) and African-Americans (38%) and most of them were representatives of an inner-city underserved population. Signiﬁcantly decreased serum levels of CoQ10 and α- tocopherol (P < .001 by the Student’s t-test) were detected in hormonal contraception users compared with nonusers (Table 1). The contraceptive patch users had the lowest serum levels of CoQ10. Serum levels of γ-tocopherol were comparable between OC users and controls. The CoQ10/cholesterol indexes were signiﬁcantly lower in the subjects who used hormonal contraception compared to nonusers, demonstrating the lowest in the patch users. The mean TAOC concentration in serum was 1.3 ± 1.0 mmol Trox equiv/l in the control group and the mean val- ues of TAOC in the contraceptive pill, ring, and patch users were 1.00 ± 0.41, 0.85 ± 0.05, and 0.65 ± 0.04 mmol Trox equiv/l, respectively (Table 1). The lowest TAOC level was observed in the transdermal patch group and was found to be statistically signiﬁcant compared with pill users (P < .05). 4. Discussion This is the ﬁrst report examining the eﬀects of exogenous ovarian hormones on serum levels of CoQ10 and vitamin E in healthy premenopausal women. Results demonstrate signiﬁcantly lower serum levels of CoQ10, α-tocopherol, and TAOC in hormonal contraception users compared to nonusers. Moreover, contraceptive patch users had the lowest levels of CoQ10 and TAOC. Data suggest that alterations in CoQ10 and α-tocopherol by hormonal contraception and the potential eﬀect(s) of exogenous ovarian hormones on oxidative stress should be taken into consideration in future antioxidant research. Of the three contraceptive formulations studied, the transdermal patch had the strongest lowering eﬀect on CoQ10 levels and TAOC. The transdermal patch has been shown to produce a steady-state of EE concentrations of 58–71 pg/ml and maximum serum concentrations of 74– 96 pg/ml [6, 7, 11]. The pharmacokinetics of the transdermal patch suggests that serum EE concentrations are higher