Combined oral contraceptive pills containing desogestrel or drospirenone enhance large vessel and microvasculature vasodilation in healthy premenopausal women

OBJECTIVE: To determine the effects of different COCs on endothelial function. BACKGROUND: COCs all contain ethinylestradiol but different progestins; three of the more common progestins are DSG LN and DR. Ethinylestradiol enhances some measures of vascular reactivity but certain progestins may increase risk of vascular diseases and impair endothelial vasodilation. METHODS: Twenty-nine healthy women taking COCs containing 30 mug ethinylestradiol and 150 mug DSG (Marvelon n = 10) 150 mug LN (Microgynon n = 10) or 3 mg DR (Yasmin n = 9) had their vascular reactivity measured using various techniques during their pill-free week (days 5-7) and the third week of active pills (days 26-28). A reference group (n = 10) underwent the same measurements on two consecutive cycles. RESULTS: FMD and LDI were significantly higher during active-pill visits than pill-free visits in women taking DSG and DR (p < 0.02) but not in women taking LN. There were no differences between the duplicate measures in the reference group. CONCLUSIONS: COCs containing 150 mug DSG or 3 mg DR significantly increase endothelium-dependent vasodilation in both large vessels and peripheral microvasculature. These effects may be due to the progestins exhibiting differential effects on eNOS expression. (c) 2011 John Wiley & Sons Ltd.