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 .
Clinical comparison of triphasic norgestimate/35 micrograms ethinyl estradiol and monophasic norethindrone acetate/20 micrograms ethinyl estradiol. Cycle control, lipid effects, and user satisfaction.
This six-cycle , multicenter , open-label , r and omized study compared the clinical experience of two low-dose oral contraceptives ( OC ) : a triphasic OC containing norgestimate ( NGM ) and 35 micrograms ethinyl estradiol ( EE ) ( Ortho Tri-Cyclen ) and a monophasic OC containing norethindrone acetate ( NETA ) and 20 micrograms EE ( Loestrin Fe 1/20 ) .  Cycle control , lipid and and rogen profiles , and user satisfaction were studied in new-start OC users ( i.e. , no prior use within 60 days ) .  Breakthrough bleeding or breakthrough spotting ( BTB/BTS ) occurred in a significantly smaller percentage of NGM/EE users than NETA/EE users during each of six cycles ( p < or = 0.002 ) . The incidence of BTB/BTS ranged from 3.7 % to 13.5 % for NGM/EE users and from 23.5 % to 49.7 % for NETA/EE users . Significantly fewer NGM/EE users than NETA/EE users experienced absence of menses at cycles 2 through 6 ( p < or = 0.003 ) . The percentages of women having no menses at each cycle ranged from 0.9 % to 4.7 % for NGM/EE users and from 10.3 % to 21.3 % for NETA/EE users . NGM/EE users reported a significantly ( p < 0.001 ) higher level of satisfaction with their OC at the end of six cycles than did NETA/EE users , but there was no significant difference in compliance , discontinuation rates , or adverse events between the two groups . NGM/EE produced a significantly ( p < or = 0.001 ) greater beneficial effect on HDL-C , HDL2 , and apo A-I than did NETA/EE . No statistically significant treatment differences were found for total cholesterol , LDL-C , triglycerides , or apo-B. Both OC increased sex hormone binding globulin and decreased free testosterone , but NGM/EE had a significantly greater effect ( p < 0.009 )
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 .