Possible Interaction: Ethinyl Estradiol and Progestins

“Use of oral contraceptives (OC) that combine a progestogen with synthetic ethinyl estradiol (EE) is associated with increased risk of venous thromboembolism.”

“BACKGROUND Ethinyl estradiol (EE) increases endothelium-dependent vasodilation in young women, but certain progestins paired with EE in combination oral contraceptive pills (OCPs) have been shown to antagonize the vasodilatory effects of EE.”

“It is therefore possible that both steroids decreased the hepatic output of triglycerides, which may be clinically important since both progestins are used in combination with ethinylestradiol (EE) which increases the hepatic TG synthesis.”

“Treatment with estrogens (specifically oral ethinylestradiol ) of transgender women, particularly in combination with progestins , carries a significant relative risk of developing cardiovascular disease (almost a twofold incidence compared to the general population).”

“Compared with progestogens with androgenic properties which may restrict the stimulatory action of ethinylestradiol on haemostatic parameters, the newer progestogens do not seem to be superior with respect to haemostasis.”

“Combined use of EE and synthetic progestogens may therefore enhance estrogen effects on body sodium and blood pressure.”

“Studies suggest an association between combinations of EE and progestogens and ischaemic stroke, which in particular concerns women with migraine.”

“RESULTS Women using … of et inyl estradiol + p … gestogen ha d significantly lower mean ASM (18.0), RSMI (6.5), TLM (40.8) (p < 0.01) and GS (34.6) (p < 0.… not using hormonal contraception with mean values of ASM (18.8), RSMI (6.7), TLM (42.6) and GS (36.9).”

“In the case of the other five reductases, gestagens had remarkably stronger inhibitory effects at a concentration of 25 μM (progesterone: 66-88% inhibition; drospirenone: 26-87% inhibition) in comparison to estrogens (estradiol: 17-51% inhibition; ethinylestradiol : 14-79% inhibition) and androgens (14-78% inhibition).”

“In recent years, there has been an important and intensive controversy regarding the thromboembolic risk of hormonal contraceptives containing ethinylestradiol combined with certain progestogens like desogestrel, drospirenone and cyproterone acetate.”