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  • Title: Serum high density lipoprotein cholesterol levels in women using a contraceptive injection of depot-medroxyprogesterone acetate.
    Author: Kremer J, de Bruijn HW, Hindriks FR.
    Journal: Contraception; 1980 Oct; 22(4):359-67. PubMed ID: 7449384.
    Abstract:
    The mean serum high density lipoprotein cholesterol (HDL-C) concentration proved to be significantly lower in 23 women taking depot-medroxyprogesterone acetate (DMPA) as a twelve-weekly injectable contraceptive for at least 1 year, as compared to 23 IUD users. In the DMPA group, no significant difference was found in the mean serum HDL-C concentration, when measured 2, 6 and 12 weeks after a DMPA injection. Epidemiologically, an inverse relation between serum HDL-C level (high density lipoprotein cholesterol) and risk for coronary heart disease has been reported. HDL has also been known to serve as a vehicle for transporting cholesterol from the arterial wall to the liver for excretion. However, there are no clinical data for the concept that a drug-decreased serum HDL-C is unfavorable with respect to atherosclerosis and myocardial infarction. This study compares the serum HDL-C level in 23 women who received depot medroxyprogesterone acetate (DMPA) as a 12-weekly injectable progestational contraceptive with that of a comparable control group of 23 IUD users. Both groups were selected on the basis of age, bodyweight, and alcohol consumption. HDL-C and serum triglyceride levels were measured by an enzymatic method. The serum HDL-C level was significantly lower in the DMPA group than in the IUD group (t=4.30, p= 0.001). The difference was attributed to the progestational effect of the DMPA. The lapse of time after a DMPA injection did not affect the serum HDL-C level, an unexpected finding as the average serum MPA level rises steeply during the 1st week after DMPA injection and then declines gradually to a relatively low value after 12 weeks. DMPA should not be prescribed to women with abnormally high risk for atherosclerosis (eg, heavy smokers, and women with adiposity and/or diabetes mellitus).
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