Oral contraceptive pills (OCPs) are commonly used for contraception, but their long-term effects on oxidative stress, lipid profiles, and liver function remain unclear. This study aimed to evaluate the impact of intermediate-term OCP use (Yasmin) on oxidative stress, lipid profile, and liver function, with particular emphasis on antioxidant markers, lipid metabolism, and hepatic enzyme activity, to better understand the potential metabolic and hepatic effects.

Methods

A case-control study was conducted in Maysan Governorate, Iraq, involving 150 women (100 OCP users and 50 non-users). Blood samples were collected from Al-Sadr Teaching Hospital and a specialized clinic between February and April 2023. Serum levels of antioxidants, lipids, and liver enzymes were measured using biochemical assays.

Results

OCP users had significantly lower levels of glutathione peroxidase vitamin E and uric acid (p < 0.001) compared to non-users. Lipid profiles showed that OCP users had higher levels of triglyceride and low-density lipoprotein (p < 0.05), whereas total cholesterol was significantly higher in non-users (p < 0.05). Liver enzyme activity, including alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total serum bilirubin, did not show statistically significant differences (p > 0.05). Longer duration of OCP use was significantly negatively correlated with vitamin E levels (r = −0.67), glutathione peroxidase activity (r = −0.56), uric acid levels (r = −0.45) and high-density lipoprotein (r = −0.54). Positive correlations were found between the duration of OCP use and total cholesterol (r = 0.62), triglyceride (r = 0.58), low-density lipoprotein (r = 0.60), and liver enzymes alanine aminotransferase (r = 0.66) and aspartate aminotransferase (r = 0.64).

Conclusions

Intermediate-term OCP use was associated with changes in oxidative stress and lipid metabolism, potentially increasing cardiovascular and metabolic risks. Regular monitoring of these parameters is recommended for OCP users.

Full text:

https://www.xiahepublishing.com/2472-0712/ERHM-2024-00035

The study was recently published in the Exploratory Research and Hypothesis in Medicine.

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Screening for risk factors of ovarian cancer using artificial intelligence, UniSA researchers found that the oral contraceptive pill reduced the risk of ovarian cancer by 26% among women who had ever used the Pill, and by 43% for women who had used the Pill after the age of 45.

The study also identified some biomarkers associated with ovarian cancer risk, including several characteristics of red blood cells and certain liver enzymes in the blood, with lower body weight and shorter stature associating with a lower risk of ovarian cancer.

Researchers also found that women who had given birth to two or more children had a 39% reduced risk of developing ovarian cancer compared to those who had not had children.

Ahead of World Cancer Day on 4 February, the findings have potential to support early diagnosis of ovarian cancer.

In Australia, ovarian cancer is the tenth most common cancer in women and the sixth most common cause of death from cancer in women.

In 2023, 1786 females were diagnosed with ovarian cancer in Australia; the same year, 1050 females died of the disease.

UniSA researcher Dr Amanda Lumsden says understanding risks and preventative factors for ovarian cancer is key for improved treatment and outcomes.

“Ovarian cancer is notoriously diagnosed at a late stage, with about 70% of cases only identified when they are significantly advanced,” Dr Lumsden says.

“Late detection contributes to a survival rate of less than 30% over five years, in comparison to more than 90% for ovarian cancers that are caught early. That’s why it’s so important to identify risk factors.

“In this research, we found that women who had used the oral contraceptive pill had a lower risk of ovarian cancer. And those who had last used the Pill in their mid-40s, had an even lower level of risk.

“This poses the question as to whether interventions that reduce the number of ovulations could be used as a potential target for prevention strategies for ovarian cancer.”

Supported by the MRFF, the study used artificial intelligence to assess the data of 221,732 females (aged 37-73 at baseline) in the UK Biobank.

Machine learning specialist, UniSA’s Dr Iqbal Madakkatel, says the study shows how artificial intelligence can help to identify risk factors that may otherwise have gone undetected.

“We included information from almost 3000 diverse characteristics related to health, medication use, diet and lifestyle, physical measures, metabolic, and hormonal factors, each measured at the start of the study,” Dr Madakkatel says.

“It was particularly interesting that some blood measures – which were measured on average 12.6 years before diagnoses – were predictive of ovarian cancer risk, because it suggests we may be able to develop tests to identify women at risk at a very early stage.”

Project Lead, Professor Elina Hyppönen, says that identifying risk factors for ovarian cancer could help to improve survival rates through prevention and earlier detection.

“It is exciting that our data-driven analyses have uncovered key risk factors for ovarian cancer that can be acted upon,” Prof Hyppönen says.

“It is possible that by using the contraceptive pill to reduce ovulations or by reducing harmful adiposity, we may be able to lower to risk of ovarian cancer. But more research is needed to establish the best approaches to prevention, as well as the ways in which we can identify women most at risk.”

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Researchers reported this finding on Oct. 14, 2021 in Diabetes Care.

Co-senior author Professor Wiebke Arlt, Director of the University of Birmingham’s (UK) Institute of Metabolism and Systems Research, said, “We knew from previous, smaller studies, that women with PCOS have an increased risk of type 2 diabetes.  However, what is important about our research is that we have been able to provide new evidence from a very large population-based study to show for the very first time that we have a potential treatment option – combined oral contraceptives – to prevent this very serious health risk.”

As background, the authors noted that irregular menstrual cycles are linked with increased cardiovascular mortality, and that  polycystic ovary syndrome (PCOS) is characterized by androgen excess and irregular menses. Likewise, androgen excess increases metabolic risk in women with PCOS. Clinicians use combination oral contraceptive pills (COCPs) in PCOS for menstrual cycle regulation and to reduce androgen excess.

Using UK patient GP records of 64,051 women with PCOS and 123,545 matched control women without PCOS, the investigators analyzed the data to discern the comparative risk of type 2 diabetes and pre-diabetes among these subjects.

They reported that women with PCOS had a doubled risk of manifesting type 2 diabetes or pre-diabetes, compared to those without PCOS.

To investigate the impact of the COPS pill on development of type 2 diabetes or pre-diabetes, the researchers conducted a further nested case control study of 4,814 women with PCOS. They found that use of combined oral contraceptives reduced the risk of developing type 2 diabetes and pre-diabetes by 26% in women with PCOS.

Co-senior author Krish Nirantharakumar, Professor in Health Data Science and Public Health at the University of Birmingham’s Institute of Applied Health Research, added: “Importantly, our data highlight that normal weight women with PCOS were also at increased risk of type 2 diabetes and pre-diabetes. This parallels our previous finding of increased NAFLD [non-alcoholic fatty liver disease] risk in normal weight women with PCOS, further challenging the notion that PCOS-related metabolic complications are only relevant in the context of obesity. These data suggest that, rather than obesity in isolation, PCOS-specific factors, including androgen excess, underpin the increased metabolic risk.”

Joint first author Anuradhaa Subramanian, research associate at the University of Birmingham, added, “With one in 10 women living with PCOS, which is a life-long metabolic disorder, it is incredibly important that we find ways of reducing its associated health risks.”

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