Sänger Nicole, Stahlberg Skadi, Manthey Torsten, Mittmann Katrin, Mellinger Uwe, Lange Evelyn, Kuhl Herbert, Wiegratz Inka
Center of Obstetrics and Gynecology, University Hospital of Frankfurt, Germany.
Contraception. 2008 Jun;77(6):420-5. doi: 10.1016/j.contraception.2008.02.005. Epub 2008 Apr 24.
This study was conducted to investigate the effects of an oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg dienogest on thyroid hormones and androgen parameters.
Thyroid and androgen parameters were measured in 59 women treated with a monophasic combined oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg dienogest (EE/DNG) either conventionally (13 cycles with 21 days of treatment+7 days without hormones) or according to an extended-cycle regimen (four extended cycles with 84 days of continuous administration of EE/DNG, followed by a hormone-free interval of 7 days). Blood samples were taken on Days 21-26 of the preceding control cycle and on Days 19-21 of the 3rd and 13th conventional cycle, or on Days 82-84 of the first and fourth extended cycle.
At both time points, the serum concentrations of thyroxine-binding globulin were elevated by about 65% in both treatment regimens. Likewise, both groups showed an increase in total triiodothyronine (T3) and total thyroxine (T4) by 30-40%, and no change in free T4. Until the 12th month of conventional treatment, the level of free T3 remained unchanged but decreased slightly during the extended-cycle regimen. In both groups there was a rise of sex hormone-binding globulin by 210-230% after 3 months and by 220-250% after 12 months. The levels of total testosterone were reduced by about 40% and those of free testosterone by 55-65% after 3 and 12 months.
The results suggest that, during conventional and extended-cycle treatment with EE/DNG, a steady state in the effects on thyroid hormones and androgen parameters was reached within 3 months and that the changes in the various hormonal parameters did not substantially differ between conventional and extended-cycle regimen.
本研究旨在调查一种含有30微克炔雌醇和2毫克地诺孕素的口服避孕药对甲状腺激素和雄激素参数的影响。
对59名使用含有30微克炔雌醇和2毫克地诺孕素（EE/DNG）的单相复方口服避孕药进行治疗的女性进行甲状腺和雄激素参数测量，治疗方式分为常规治疗（13个周期，每个周期21天治疗+7天无激素间隔）或延长周期方案（四个延长周期，连续服用EE/DNG 84天，随后有7天无激素间隔）。在前一个对照周期的第21 - 26天以及第3个和第13个常规周期的第19 - 21天，或第一个和第四个延长周期的第82 - 84天采集血样。
在两个时间点，两种治疗方案中甲状腺素结合球蛋白的血清浓度均升高了约65%。同样，两组总三碘甲状腺原氨酸（T3）和总甲状腺素（T4）均升高了30 - 40%，游离T4无变化。在常规治疗的第12个月之前，游离T3水平保持不变，但在延长周期方案中略有下降。两组中，性激素结合球蛋白在3个月后升高210 - 230%，12个月后升高220 - 250%。3个月和12个月后，总睾酮水平降低约40%，游离睾酮水平降低55 - 65%。
结果表明，在使用EE/DNG进行常规和延长周期治疗期间，3个月内对甲状腺激素和雄激素参数的影响达到稳定状态，并且常规和延长周期方案之间各种激素参数的变化没有实质性差异。
