Journal
EUROPEAN JOURNAL OF CONTRACEPTION AND REPRODUCTIVE HEALTH CARE
Volume 18, Issue 6, Pages 489-500Publisher
INFORMA HEALTHCARE
DOI: 10.3109/13625187.2013.822061
Keywords
Oral contraception; Androgens; DHEA; DHEA-S; Testosterone; Pharmacokinetics
Funding
- Andromed
- Ardana
- Auxogyn
- Ferring
- Genovum
- Merck (MSD)
- Merck Serono
- Organon
- Pantharei Bioscience
- PregLem
- Schering
- Schering Plough
- Serono
- Uteron Pharma
- Watson Pharmaceuticals
- Wyeth
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Background Combined oral contraceptives (COCs) reduce the levels of ovarian and adrenal androgens. Co-administration of dehydroepiandrosterone (DHEA) may normalise androgen levels during COC use. Objective To investigate the effect of the addition of DHEA to a COC on the pharmacokinetics (PK) and pharmacodynamics (PD) of DHEA and its sulphate (DHEA-S), and on levels of total and free testosterone (T). Methods In a prospective, randomised, double-blind, placebo-controlled, cross-over study involving 21 female volunteers, the PK and PD of DHEA and DHEA-S were investigated during the use of one cycle of a COC containing 30 mu g ethinylestradiol (EE) and 3 mg drospirenone (DRSP) with and without daily co-administration of 50 mg DHEA. Results Treatment during one cycle with a COC containing EE and DRSP reduces the exposure to DHEA and DHEA-S by at least 20%. This loss of adrenal androgens can be fully compensated by daily oral co-administration of 50 mg DHEA. With DHEA co-administration total T levels rise significantly (1.44 nmol/L with DHEA vs. 0.82 nmol/L with placebo; p < 0.001). Free T levels decrease significantly with both DHEA and placebo treatment, but significantly less during co-administration of DHEA (6.34 pmol/L with DHEA vs. 3.96 pmol/L with placebo; p < 0.001). Conclusion By adding DHEA to a COC the loss of adrenal and ovarian androgens can be restored.
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