Effects of switching from oral to transdermal or transvaginal contraception on markers of thrombosis

Jeffrey Jensen, Anne E. Burke, Kurt T. Barnhart, Carrie Tillotson, Marci Messerle-Forbes, Dawn Peters

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: The study was conducted to determine the impact of switching from oral to transdermal patch or vaginal ring contraception on biomarkers of thrombosis. Study Design: Current healthy oral contraceptive (OC) users were randomized to switch to either a contraceptive ring (CR) or patch (CP) and underwent phlebotomy to measure surrogate biomarkers of thrombosis [sex hormone-binding globulin (SHBG), free protein S and activated protein C resistance (APC-r)] before switching, and during the fourth cycle of use of the new method. Results: Of 142 reproductive age women enrolled, 120 sample pairs were available for analysis. SHBG increased significantly from baseline in CP users [mean change (95% CI), +29.9 nM (9.6-50)] but not in CR users [-1.6 (-16.6 to 13.5)]. Protein S decreased significantly from baseline in CP users [mean change -7.1% (-12.1 to -2.1)], but increased significantly in CR users [+5.3% (1.1-9.6)]. The APC-r ratio did not undergo a significant change from baseline in either group [CP +0.06 (-0.06 to 0.18), CR +0.02 (-0.10 to 0.14)]. Compared to CR users, subjects using the CP had significantly higher SHBG [187.5 (167.0-208), 146 (132.6-159.4), p=.012], significantly lower protein S [81.8 (76.8-86.8), 93.6 (89.1-98.1), p=.001] and similar APC-r ratios [2.99 (2.85-3.14), 3.09 (2.96, 3.22), p=.3] at the Cycle 4 visit. Conclusion: OC users who switch to the ring exhibit beneficial changes in biomarkers of thrombosis, while those switching to the patch display a shift favoring clot formation.

Original languageEnglish (US)
Pages (from-to)451-458
Number of pages8
JournalContraception
Volume78
Issue number6
DOIs
StatePublished - Dec 2008

Fingerprint

Contraceptive Agents
Contraception
Activated Protein C Resistance
Thrombosis
Sex Hormone-Binding Globulin
Protein S
Biomarkers
Oral Contraceptives
Female Contraceptive Devices
Transdermal Patch
Phlebotomy

Keywords

  • Hormonal contraception
  • Randomized
  • Thrombosis
  • Transdermal
  • Transvaginal

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Effects of switching from oral to transdermal or transvaginal contraception on markers of thrombosis. / Jensen, Jeffrey; Burke, Anne E.; Barnhart, Kurt T.; Tillotson, Carrie; Messerle-Forbes, Marci; Peters, Dawn.

In: Contraception, Vol. 78, No. 6, 12.2008, p. 451-458.

Research output: Contribution to journalArticle

Jensen, Jeffrey ; Burke, Anne E. ; Barnhart, Kurt T. ; Tillotson, Carrie ; Messerle-Forbes, Marci ; Peters, Dawn. / Effects of switching from oral to transdermal or transvaginal contraception on markers of thrombosis. In: Contraception. 2008 ; Vol. 78, No. 6. pp. 451-458.
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abstract = "Background: The study was conducted to determine the impact of switching from oral to transdermal patch or vaginal ring contraception on biomarkers of thrombosis. Study Design: Current healthy oral contraceptive (OC) users were randomized to switch to either a contraceptive ring (CR) or patch (CP) and underwent phlebotomy to measure surrogate biomarkers of thrombosis [sex hormone-binding globulin (SHBG), free protein S and activated protein C resistance (APC-r)] before switching, and during the fourth cycle of use of the new method. Results: Of 142 reproductive age women enrolled, 120 sample pairs were available for analysis. SHBG increased significantly from baseline in CP users [mean change (95{\%} CI), +29.9 nM (9.6-50)] but not in CR users [-1.6 (-16.6 to 13.5)]. Protein S decreased significantly from baseline in CP users [mean change -7.1{\%} (-12.1 to -2.1)], but increased significantly in CR users [+5.3{\%} (1.1-9.6)]. The APC-r ratio did not undergo a significant change from baseline in either group [CP +0.06 (-0.06 to 0.18), CR +0.02 (-0.10 to 0.14)]. Compared to CR users, subjects using the CP had significantly higher SHBG [187.5 (167.0-208), 146 (132.6-159.4), p=.012], significantly lower protein S [81.8 (76.8-86.8), 93.6 (89.1-98.1), p=.001] and similar APC-r ratios [2.99 (2.85-3.14), 3.09 (2.96, 3.22), p=.3] at the Cycle 4 visit. Conclusion: OC users who switch to the ring exhibit beneficial changes in biomarkers of thrombosis, while those switching to the patch display a shift favoring clot formation.",
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