Original research article The effects of two progestogen-only pills containing either desogestrel (75 g/day) or levonorgestrel (30 g/day) on lipid metabolism

The effects of two progestogen-only pills (POPs) containing either desogestrel (75 g/day) or levonorgestrel (30 g/day) on lipid metabolism were compared in a double-blind, randomized study in Sweden and Finland. Eighty-one healthy female volunteers received either desogestrel 75 g/day or levonorgestrel 30 g/day for seven treatment periods of 28 days. The following lipid parameters were measured at screening and at treatment Periods 3 and 7: total cholesterol, total triglycerides, HDL-cholesterol, HDL 2-cholesterol, HDL3-cholesterol, LDL-cholesterol, apolipoprotein A-I, apolipoprotein A-II, apolipoprotein B, lipoprotein (a), and the carrier proteins sex hormone-binding globulin (SHBG) and cortisol-binding globulin. Overall, both study medications had similar, minimal effects on lipid metabolism. To summarize, compared with pre-treatment, no changes were observed for LDL-cholesterol and its protein fraction apolipoprotein B. The concentrations of total cholesterol and triglycerides decreased marginally. Decreasing trends were also seen for lipoprotein (a), HDL-cholesterol and its subfractions, HDL2-cholesterol and HDL3-cholesterol, and the apolipoproteins, apolipoprotein A-I and apolipoprotein A-II. The results indicated no significant differences between the groups in any of the parameters, with the exception of a smaller decrease in HDL3-cholesterol at treatment Period 7 for the desogestrel-containing POP compared with the levonorgestrelcontaining POP and a significant difference between the two treatments for lipoprotein (a) at Period 3. The serum concentration of the carrier protein SHBG was found to be slightly higher in the desogestrel group, which may be a manifestation of the higher androgenicity of levonorgestrel compared with desogestrel. It can be concluded that the POP containing 75 g desogestrel has a negligible effect on lipid metabolism. Despite the higher progestogen dose, the effect of this new POP is similar to that of a traditional POP containing 30 g levonorgestrel. © 2001 Elsevier Science Inc. All rights reserved.