Effects of oral contraceptive combinations containing levonorgestrel or desogestrel on serum proteins and androgen binding

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Abstract
The effects of the oral contraceptive combinations 0.125 mg Org 2969 (desogestrel) (13-ethyl-11-methylene-18, 19-dinor-17α-pregn-4-en-20-yn-17—01) + 0.05 mg ethinyloestradiol (EE) and 0.125 mg levonorgestrel + 0.05 mg EE on serum sex-hormone-binding globulin (SHBG), ceruloplasmin, transcortin and ratio free testosterone over total testosterone (percentage free testosterone) and ratio free 5α-dihydrotestosterone over total 5α-dihydrotestosterone (percentage free 5α-dihydrotestosterone) were compared in healthy female volunteers. Treatment was randomly distributed over the volunteers; 11 women received Org 2969 + EE and 11 women received levonorgestrel + EE. These combinations induced similar increases in transcortin levels (115 and 140%) and ceruloplasmin levels (115 and 123 %) after 3 months of treatment. However, the combination Org 2969 + EE induced a substantial increase (213%) in SHBG capacity after 3 months of treatment, whereas a smaller increase (80%) was observed with levonorgestrel + EE. A return to pretreatment values was observed 2 months after termination of treatment for all parameters. The difference in the effects of both preparations on SHBG was statistically significant and can be best explained by a difference in the androgenicity of the progestogens. A good correlation was observed between SHBG capacity and the reciprocal value of the percentage free testosterone and the reciprocal value of the percentage free 5α-dihydro-testosterone. These results confirm that SHBG is the major regulator of the biologically active free androgen fraction in women before, during and after combined oral contraceptive treatment.

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