Hormone-releasing contraceptive may pose diabetes risk for obese women

Washington, Fri, 08 Feb 2013 ANI

Washington, February 8 (ANI): Healthy, obese, reproductive-age women who use long-acting reversible contraception (LARC) containing the hormone progestin have a slightly increased risk for developing type 2 diabetes when compared to those who use non-hormonal contraception, a new study has found.

The first-of-its-kind study by researchers at the Keck School of Medicine of the University of Southern California (USC) concluded that progestin-releasing LARC appears to be safe for use by such women but needs further investigation.

Obese women are at increased risk for pregnancy-related complications and are sometimes warned by their doctors not to use contraceptives containing estrogen, such as the pill, patch and vaginal ring.

"[Those choices] raise the risk for blood clots. So they need other, viable alternatives. The implanted LARC devices last three to 10 years, are easily reversible, and women don't have to remember to do anything with them, in contrast to the birth-control pill," said Penina Segall-Gutierrez, co-investigator of the study and an assistant professor of clinical obstetrics and gynecology and family medicine at the Keck School.

The six-month study observed the metabolic markers in three groups of obese women: a control group using non-hormonal birth control methods, including condoms, the copper IUD, and female or male sterilization; a second group with a progestin-releasing LARC device implanted in the uterus (IUD); and a third group with a progestin-releasing LARC device implanted under the skin.

"All three methods were found to be safe and effective, and they did not create changes in blood pressure, weight, or cholesterol. However, there was a 10 percent increase in fasting blood-glucose levels among the skin implant users, compared to a 5 percent increase among the IUD users and a 2 percent decrease among those using non-hormonal methods," Segall-Gutierrez said.

"The effects on sensitivity to insulin showed a similar trend. It is unknown if these effects would continue if the devices were used and studied for a longer period of time," She added.

Segall-Gutierrez and her Keck research partners have studied the metabolic effects of other birth-control methods as well. In 2012, they reported findings that obese women receiving a progestin birth-control shot every three months may be at increased risk for developing type 2 diabetes.

"Overall, we're finding that methods such as the progestin injection and the progestin skin implant, which both have higher circulating progestin, may have an increased risk for metabolic changes compared to methods like the IUD, which only has a local effect - in the uterus," she said.

Segall-Gutierrez added that the progestin-releasing IUD has other benefits. It is approved by the U.S. Food and Drug Administration for treatment of heavy menstrual bleeding, which often affects obese women. The IUD also protects against endometrial cancer, which disproportionately affects obese women.

Nicole M. Bender, assistant professor of clinical obstetrics and gynecology at the Keck School, was the principal investigator for the study that appeared online in the journal Contraception. (ANI)



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