However , subgroup analyses for the estrogen dose and the progestin type in relation to changes in SHBG levels did show significant differences : COCs containing second generation progestins and /or the lower estrogen doses ( 20–25 µg EE ) were found to have less impact on SHBG concentrations .
The current literature review and meta- analysis demonstrates that COCs decrease circulating levels of total T and free T and increase SBHG concentrations .
Due to the SHBG increase , free T levels decrease twice as much as total T. The estrogen dose and progestin type of the COC do not influence the decline of total and free T , but both affect SHBG .
BACKGROUND Combined oral contraceptives ( COCs ) reduce levels of and rogen , especially testosterone ( T ) , by inhibiting ovarian and adrenal and rogen synthesis and by increasing levels of sex hormone-binding globulin ( SHBG ) .
Although this suppressive effect has been investigated by numerous studies over many years , to our knowledge no systematic review concerning this issue had been performed .
Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol on ovarian function in comparison to a monophasic combined oral contraceptive containing drospirenone and ethinylestradiol
Objective To compare the effects on ovarian activity of two oral contraceptives containing nomegestrol acetate (NOMAC)/17β-oestradiol ( E2 ) or drospirenone (DRSP)/ethinylestradiol ( EE ) . Methods In this open-label , r and omised , six-cycle study , 32 subjects using NOMAC/E2 ( 2.5–1.5 mg ; 24/4-day regimen ) were compared to 16 subjects using DRSP/EE ( 3 mg–30 μg ; 21/7-day regimen ) . Measurements included serum oestradiol , progesterone , follicle stimulating hormone ( FSH ) and luteinising hormone ( LH ) , and ultrasonography of follicular diameter . Results No ovulations occurred during treatment . Progesterone was fully suppressed , with mean maximum values < 2 nmol/l in both groups over all cycles . For NOMAC/E2 , mean maximum follicular diameter decreased from 19.3 mm before treatment to between 6.9 and 8.2 mm during treatment , with no subject having a follicular diameter ≥15 mm . For DRSP/EE , a decrease from 19.6 to between 7.4 and 10.8 mm was observed , with two subjects ( 12.5 % ) having a maximum follicle diameter ≥15 mm . These findings were consistent with observed FSH reductions ; full suppression of LH surges was observed in both groups . Post-treatment return of ovulation in both groups occurred on average 21 days after the last active tablet intake . Conclusions NOMAC/E2 achieves consistent ovulation inhibition , with suppressive effects on the ovaries at least similar to those of DRSP/EE
However , subgroup analyses for the estrogen dose and the progestin type in relation to changes in SHBG levels did show significant differences : COCs containing second generation progestins and /or the lower estrogen doses ( 20–25 µg EE ) were found to have less impact on SHBG concentrations .
The current literature review and meta- analysis demonstrates that COCs decrease circulating levels of total T and free T and increase SBHG concentrations .
Due to the SHBG increase , free T levels decrease twice as much as total T. The estrogen dose and progestin type of the COC do not influence the decline of total and free T , but both affect SHBG .
BACKGROUND Combined oral contraceptives ( COCs ) reduce levels of and rogen , especially testosterone ( T ) , by inhibiting ovarian and adrenal and rogen synthesis and by increasing levels of sex hormone-binding globulin ( SHBG ) .
Although this suppressive effect has been investigated by numerous studies over many years , to our knowledge no systematic review concerning this issue had been performed .