A study of glucose tolerance, serum transaminase and lipids in women using depot-medroxyprogesterone acetate and a combination-type oral contraceptive

The metabolic effects of the 3-month injectable preparation depomedroxyprogesterone acetate (DMPA; Depo-Provera) 150 mg and of the combined oral contraceptive Ovral (d-norgestrel .05 mg plus ethinyl estradiol .05 mg) in a Thai population were assessed in a longitudinal study. Subjects were 2 groups of 16 women each from the Family Planning Clinic. A rapid intravenous glucose tolerance test (IVGTT) was done on both groups and at 1 2 3 6 9 and 12 months after drug administration. Plasma insulin levels were determined before and at 1 9 and 12 months posttherapy. Serum transaminase activity (SGOT and SGPT) triglyceride and total cholesterol levels were also determined. Results of the IVGTT are given as K values (disappearance rate of glucos e %/minute). In the DMPA group at 12 months the 1st significant decrease in mean fasting blood glucose levels was noted. The serum triglyceride levels tended to be lower throughout the 12 months of observation. Total cholesterol levels were significantly decreased after 9 and 12 months of DMPA use. SGOT AND SGPT and body weights remained the same. The K values were significantly increased during the observation period but less so toward the end of the period. Mean fasting plasma insulin was unchanged but some of the early plasma insulin responses were significantly increased. In the Ovral group the fasting blood glucose was significantly lower after 3 months of treatment. Serum triglyceride remained unchanged. Cholesterol levels tended to be lower during the first 6 months. SGOT and SGPT levels remained the same. Body weights were significantly increased. The mean K value did not change significantly but some were lower. Fasting plasma insulin remained the same but the plasma insulin responses to glucose load were significantly increased throughout the period particularly late during the observation period. Not all of the results agree with the works of some other investigators. It is concluded that DMPA caused a beneficial effect on carbohydrate metabolism without deterioration of lipid metabolism or liver function. Ovral did not induce any significant change in the K value although plasma insulin levels increased some during the test. Ovral did not induce any change in liver function or lipid metabolism except transient lowering of cholesterol values.