Serum High-Density-Lipoprotein Cholesterol in Women Using Oral Contraceptives, Estrogens and Progestins

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Abstract
To determine the associations between high-density-lipoprotein cholesterol levels and use of oral contraceptives or of noncontraceptive estrogens and progestins we analyzed the serum levels of this lipid in 4978 women, 21 to 62 years of age. In estrogen users, the mean level was 6.7 to 15.1 mg per deciliter above the nonuser level (P<0.001), whereas in a group of progestin users it was 15.8 mg per deciliter below (P<0.001). In women using combination oral contraceptives, the level varied with the type and dose of the component steroids, in general increasing with increasing dose of estrogen and decreasing with increasing dose or potency of progestin. Thus, the net effect of use of a combination oral contraceptive on high-density-lipoprotein cholesterol depends on its formulation. (N Engl J Med 299:17–20, 1978)