A number of side effects have been linked to the use of hormonal contraceptives, among others, alterations in glucose levels. Hence, the objective of this mini-review is to show the main effects of hormonal contraceptive intake on glycemic regulation. First, the most relevant studies on this topic are described, then the mechanisms that might be accountable for this glycemic regulation impairment as exerted by hormonal contraceptives are discussed. Finally, we briefly discuss the ethical responsibility of health professionals to inform about the potential risks on glycemic homeostasis regarding hormonal contraceptive intake.
AlonsoA., LlanezaP., and GonzálezC.2008. Síndrome Metabólico, Obesidad y Terapia Hormonal de Sustitución. Revista Española de Obesidad6: 340–50.
2.
CagnacciA., FerrariS., TirelliA., ZaninR., and VolpeA.2009. Route of administration of contraceptives containing desogestrel/etonorgestrel and insulin sensitivity: A prospective randomized study. Contraception80: 34–9.
3.
Christin-MaitreS.2013. Preface: What should be known about oral contraceptive drugs. Best Practice & Research Clinical Endocrinology & Metabolism27: 1–2.
4.
DjerassiC., MiramontesL., RosenkranzG., and SondheimerF.1954. Steroids. LIV. Synthesis of 19-Nor-17α-ethynyltestosterone and 19-Nor-17α-methyltestosterone. Journal of the American Chemical Society76: 4092–4.
5.
FehringR., KlausH., and WilliamsW.V.2012. Mandates and morals. The Linacre Quarterly79: 9–13.
6.
FriedrichA., LudwigA.K., Jauch-CharaK., LoebigM., RudolfS., TauchertS., DiedrichK., SchweigerU., and OltmannsK.M.2012. Oral contraception enhances growth hormone responsiveness to hyper- and hypoglycaemia. Diabetic Medicine29: 345–50
7.
GodslandI.F., WaltonC., FeltonC., ProudlerA., PatelA., and WynnV.1992. Insulin resistance, secretion, and metabolism in users of oral contraceptives. The Journal of Clinical Endocrinology & Metabolism74: 64–70.
8.
GodslandI.F., CrookD., SimpsonR., ProudlerT., FeltonC., LeesB., AnyaokuV., DevenportM., and WynnV.1990. The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. The New England Journal of Medicine323: 1375–81.
9.
GoldmanL., and DennisA.2004. Approach to medicine, the patient, and the medical profession: Medicine as learned and humane profession. In Cecil's text book of medicine, ed. CecilR.L.F., GoldmanL., and AusielloD.A., 1–2. Philadelphia: Saunders.
10.
GonzálezC., AlonsoA., GruesoN.A., DíazF., EstebanM.M., FernándezS., and PattersonA.M.2002. Role of 17 β-estradiol administration on insulin sensitivity in the rat: Implications for the insulin receptor. Steroids67: 993–1005.
11.
GreenfieldM.S., DoberneL., KraemerF., TobeyT., and ReavenG.1981. Assessment of insulin resistance with the insulin suppression test and the euglycaemic clamp. Diabetes30: 387–92.
12.
HowellS.L., TyhurstM., and GreenI.C.1977. Direct effects of progesterone on rat islets of Langerhans in vivo and in tissue culture. Diabetologia13: 579–83.
13.
MastorakosG., KoliopoulosC., DeligeoroglouE., Diamanti-KandarakisE., and CreatsasG.2006. Effects of two forms of combined oral contraceptives on carbohydrate metabolism in adolescents with polycystic ovary syndrome. Fertility and Sterility85: 420–7.
14.
MiramontesL., RosenkranzG., and DjerassiC.1951. Steroids. 22. The synthesis of 19-nor-progesterone. Journal of the American Chemical Society73: 3540–1.
15.
NadalA., RoviraJ.M., LaribiO., León-QuintoT., AndreuE., RipollC., and SoriaB.1998. Rapid insulinotropic effect of 17β-estradiol via a plasma membrane receptor. The FASEB Journal12: 1341–8.
16.
NadalA., DíazM., and ValverdeM.A.2001. The estrogen trinity: Membrane, cytosolic, and nuclear effects. News in Physiological Sciences16: 251–5.
17.
NorrisC.W.2013. Why NFP. The Linacre Quarterly80: 218–21.
18.
ParraD.2013. La Obligación de Informar al Paciente. Cuestiones Sobre el Derecho a Ser Informado. Revista Médica de Chile141: 1578–83.
19.
PatiñoV.M., Díaz-ToledoB., and del BarrioP.G.2008. Anticoncepción en la Mujer con Diabetes. Avances en Diabetología24: 205–9.
20.
PeckR., and NorrisC.W.2012. Significant risks of oral contraceptives (OCPs): Why this drug class should not be included in a preventive care mandate. Linacre Quarterly79: 41–56.
21.
PeiD., JonesC.N.O., BhargavaR., ChenY.D.I., and ReavenG.M.1994. Evaluation of octreotide to assess insulin-mediated glucose disposal by the insulin suppression test. Diabetologia37: 843–5.
22.
PérezR., GonzálezE., OrtegaL., and ArbuésJ.1987. Alteraciones del Metabolismo Hidrocarbonado Inducidas por los Anticonceptivos Orales. Clínica e Investigación en Ginecología y Obstetricia14: 95–9.
23.
PicardF., WanatabeM., SchoonjansK., LydonJ., O'MalleyB.W., and AuwerxJ.2002. Progesterone receptor knockout mice have an improved glucose homeostasis secondary to β-cell proliferation. Proceedings of the National Academy of Sciences of the United States of America99: 15644–8.
24.
PiltonenT., PuurunenJ., HedbergP., RuokonenA., MuttS.J., HerzigK.H., NissinenA., Morin-PapunenL., and TapanainenJ.S.2012. Oral, transdermal and vaginal combined contraceptives induce an increase in markers of chronic inflammation and impair insulin sensitivity in young healthy normal-weight women: A randomized study. Human Reproduction27: 3046–56.
25.
SalhanickH.A., KipnisD.M., and Vande WieleR.L., eds. 1969. Metabolic effects of gonadal hormones and contraceptive steroids. New York: Plenum Press.
26.
ShammaF.N., RossiG., HajHassanL., PenziasA.S., Connoly-DiamondM., JonesE., and DiamondM.P.1995. The effect of norplant on glucose metabolism under hyperglycemic hyperinsulinemic conditions. Fertility and Sterility63: 767–72.
27.
ShaweJ., and LawrensonR.2003. Hormonal contraception in women with diabetes mellitus: Special considerations. Treatments in Endocrinology2: 321–30.
28.
SimonD., SenanC., GarnierP., Saint-PaulM., GaratE., ThibultN., and PapozL.1990. Effects of oral contraceptives on carbohydrate and lipid metabolisms in a healthy population: The telecom study. American Journal of Obstetrics and Gynecology163: 382–7.
29.
Sitruk-WareR., and NathA.2013. Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills. Best Practice & Research: Clinical Endocrinology & Metabolism27: 13–24.
30.
SkoubyS.O., KühlC., Mølsted-PedersenL., PetersenK., and ChristensenM.S.1985. Triphasic oral contraception: Metabolic effects in normal women and those with previous gestational diabetes. American Journal of Obstetrics and Gynecology153: 495–500.
31.
SkoubyS.O., PetersenK.R., and JespersenJ.1996. Screening for disturbances in glucose metabolism: Can it prevent cardiovascular disease in pill users? InEvidence-guided prescribing of the pill, ed. HannafordP.C., and WebbA.M.C., 99–108. London: Parthenon Publishing.
32.
SkoubyS.O., AndersenO., SaurbreyN., and KühlC.1987. Oral contraception and insulin sensitivity: In vivo assessment in normal women and women with previous gestational diabetes. The Journal of Clinical Endocrinology & Metabolism64: 519–23.
33.
SpellacyW.N.1969. A review of carbohydrate metabolism and the oral contraceptives. American Journal of Obstetrics and Gynecology104: 448–60.
34.
SpellacyW.N., BuhiW.C., and BirkS.A.1975. Effects of norethindrone on carbohydrate and lipid metabolism. Obstetrics and Gynecology46: 560–3.
35.
Sutter-DubM.T.2002. Rapid non-genomic and genomic responses to progestogens, estrogens, and glucocorticoids in the endocrine pancreatic B cell, the adipocyte and other cell types. Steroids67: 77–93.
36.
VigilP., BlackwellL.F., and CortésM.E.2012. The importance of fertility awareness in the assessment of a woman's health: A review. The Linacre Quarterly79: 426–50.
37.
VigilP., ContrerasP., AlvaradoJ.L., GodoyA., SalgadoA.M., and CortésM.E.2007. Evidence of subpopulations with different levels of insulin resistance in women with polycystic ovary syndrome. Human Reproduction22: 2974–80.
38.
WaineH., FriedenE.H., CaplanH.Z., and ColeT.1963. Metabolic effects of enovid in rheumatoid patients. Arthritis & Rheumatism6: 796–796.
39.
WatanabeR.M., AzenC.G., RoyS., PerlmanJ.A., and BergmanR.N.1994. Defects in carbohydrate metabolism in oral contraceptive users without apparent metabolic risk factors. The Journal of Clinical Endocrinology and Metabolism79: 1277–83.
40.
WynnV., AdamsP.W., GodslandI., MelroseJ., NiththyananthanR., OakleyN.W., and SeedM.1979. Comparison of effects of different combined oral-contraceptive formulations on carbohydrate and lipid metabolism. The Lancet1: 1045–9.
