Changes in Insulin Receptors during Oral Contraception*

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Abstract
Combined estrogen/progestagen oral contraceptives(OC) have been reported to be associated with a deteriorationof glucose tolerance and a decrease in insulin sensitivity;thus, since it has been suggested that steroids affect insulinreceptor properties, the influence of OC on insulin receptors wasinvestigated. The study groups were composed of nine normal menstruatingwomen (controls), nine pill users, and two healthy women onOC for the first time. Insulin receptors on monocytes wereevaluated at 7-day intervals during the 28 days between menses.Insulin receptor concentration and/or affinity did not show anyvariation in pill users during the test period and did not differfrom values observed in controls in the luteal phase; consequently,the insulin receptor concentration in pill users is lowerthan that during the follicular phase or in men. The physiologicalvariation of insulin receptor concentration and the increase ofreceptor affinity in the midfollicular phase, which characterizethe normal menstrual cycle, are therefore abolished by OC. Thiseffect occurs rapidly because it was also evident in the twowomen on OC for the first time. No difference was observed in fasting blood glucose and serumimmunoreactive insulin concentrations between control subjectsand pill users. The present data appear to confirm that sex steroids affectthe insulin receptor and lend further support to the concept thatcaution must be used in clinical studies of insulin receptors whenwomen are included. In addition, the results suggest that insulinreceptors may play a role in the glucose intolerance and insulininsensitivity which have been described in pill users.

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