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Hormones May Remain Altered One Year After Oral Contraceptive Discontinuation: Presented at AACE
By Maggie Schwarz
WASHINGTON, DC -- May 27, 2005 -- "The sexual dysfunction and androgen insufficiency seen with use of oral contraceptives can remain even a year after stopping the medication," according to Claudia Panzer, MD, a fellow in clinical endocrinology at Boston University Medical Center in Boston, Massachusetts, United States.
Dr. Panzer and associates studied 102 women reporting sexual dysfunction who were either taking or had taken an oral contraceptive. They presented their findings here May 19th at the American Association of Clinical Endocrinologists (AACE) 14th Annual Meeting and Clinical Congress.
Oral contraceptives are known to lower serum testosterone levels by decreasing ovarian production of testosterone and raising production of sex hormone-binding globulin (SHBG) from the liver. It has been assumed that these changes are reversible once a woman stops taking an oral contraceptive.
Dr. Panzer and colleagues noticed that SHBG levels can remain elevated for prolonged periods and decided to investigate SHBG levels after discontinuation of oral contraceptives.
Twenty-three women who had never taken oral contraceptives served as controls. In 62 women who were currently taking oral contraceptives and 40 women who had recently discontinued taking them, SHBG values were measured at baseline and <90 days, 90 to 180 days, and >180 days after discontinuing oral contraceptives.
SHBG values in the oral contraceptive user group were seven times higher than those in the control group (mean, 135 +/- 57% vs 19 +/- 16%; P < .01). Despite a decrease in SHBG values after discontinuation of oral contraceptive use, SHBG levels remained elevated in comparison with those in the control group (P < .01 for <90 days; P < .05 for 90 to 180 days; and P < .01 for >180 days).
Oral contraceptives lower the free androgen index, in part by substantially raising SHBG levels. SHBG levels remained continuously elevated by up to 1 year after discontinuing oral contraceptive use.
The investigators concluded that hormonal changes induced by oral contraceptives are not immediately reversible after discontinuation of the medication, as previously thought. The free androgen index may remain low for a prolonged period -- in this case, up to a year.
[Presentation title: Androgen Insufficiency And Oral Contraceptives: A Pathophysiologic Mechanism. AACE: 728.]
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