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 .
Effect of oral versus transdermal steroidal contraceptives on androgenic markers.
OBJECTIVE The purpose of this study was to compare biochemical and rogen profiles in women treated with the contraceptive patch versus an oral contraceptive ( OC ) . STUDY DESIGN Twenty-four healthy women were r and omly assigned to receive 3 cycles of either the contraceptive patch ( ethinyl estradiol [ EE ] 20 microg/d and norelgestromin 150 microg/d ) or OC ( EE 35 mug and norgestimate 250 microg ) . Blood sample s were taken at baseline and end of treatment . Serum levels of sex hormone-binding globulin ( SHBG ) , total testosterone ( T ) , and rostenedione ( A ) , dehydroepi and rosterone sulfate ( DHEAS ) , dihydrotestosterone ( DHT ) , and 3alpha- and rostanediol glucuronide ( 3alpha-diol G ) were quantified by immunoassay methods ; free T was calculated . The paired t and Student t tests were used for statistical analysis . RESULTS Nineteen women completed the study ( patch , n = 10 ; OC , n = 9 ) . Despite a 1.6-fold relative increase in SHBG levels with the patch versus OC ( 449 % vs 274 % , P = .03 ) , free T decreased equally in both groups ( patch 60 % , P < .0001 ; OC 59 % , P < .0001 ) . DHEAS decreased by 26 % in the patch group ( P < .01 ) and 32 % in the OC group ( P < .001 ) . 3alpha-diol G was reduced by 52 % in the patch group ( P < .0001 ) and 51 % in the OC group ( P < .0001 ) . In addition , the OC was associated with significant decreases in A and DHT . CONCLUSION The contraceptive patch had an effect comparable to the OC on several key and rogenic markers . Given these biochemical findings , the contraceptive patch has significant potential as a therapeutic agent for disorders of and rogen excess
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 .