Contraceptive use, both oral and parenteral, is associated with increased arterial stiffness in young healthy women.

Abstract

Purpose: Previous studies on the impact on arterial health of contraceptive use, or across the menstrual phases, have yielded differing results. Furthermore, there is little research on the differences based on the delivery method of the contraceptive, oral vs parenteral contraceptives. In this study, we examined arterial health using three different physiological measures of arterial function and structure in contraceptive users and non-users.

Methods: Young, healthy women, between 18.0-25.9 years of age were enrolled in the study (n = 577). Menstrual phase and contraceptive use and type were assessed by questionnaire. Arterial stiffness was measured using pulse-wave velocity (PWV) and augmentation index (AIx). Arterial thickness was measured using carotid-intima media thickness (cIMT). Blood samples were analysed for various biomarkers, which were used in multivariate regressions to adjust for the effects of contraceptive use on vascular status.

Results: Contraceptive users had a higher PWV than non-users. The menstrual phase did not impact PWV. In a smaller subgroup analysis, comparing the types of contraceptives, oral or parenteral, did not impact PWV. AIx and cIMT did not differ significantly between any studied groups. Systolic blood pressure, BMI, serum lipids, C-reactive protein, and sex hormone binding globulin concentrations were higher in the contraceptive using group, but in multivariable models, these biomarkers had only limited impact on the association between contraceptive use and PWV.

Conclusion: In a population of young, healthy women, contraceptive users displayed higher PWV values. The effect could not be explained by the effect of contraceptives on androgenicity, blood pressure or lipids.