Effect of depo-medroxyprogesterone acetate on coagulation factors and serum lipids in Egyptian women.

ABSTRACT

The short-term (3 months) and long-term (15 months) effect of DMPA contraception on various coagulation parameters (predictive of thrombosis) and on serum lipids (predictive of atherosclerosis) were prospectively studied in 30 Egyptian women, compared to their pretreatment levels. There were no significant changes in all the coagulation parameters studied after 3 months, and there was only a significant reduction in antithrombin III (AT III) level after 15 months (p less than 0.01). Concerning serum lipids, after 3 months, there were no significant changes in total lipids (TL), total cholesterol (TC) and triglycerides (Tg), while there was a significant decrease in high density lipoprotein cholesterol (HDL-C) (p less than 0.001), and a significant increase in low density lipoprotein cholesterol (LDL-C) (p less than 0.01). After 15 months there was a significant increase in TL, TC and LDL-C (p less than 0.001) and a significant decrease in HDL-C (p less than 0.001). Lipoprotein electrophoresis showed no significant change in pre-beta-lipoprotein percent, a significant decrease in alpha-lipoprotein percent and a significant increase in beta-lipoprotein percent after 3 and 15 months (p less than 0.001). Beta-lipoprotein band increased in 50% of DMPA users after 3 months and in 90% after 15 months and the type of hyperlipoproteinaemia was IIa. All calculated atherogenic indices showed significant changes (p less than 0.001) after 3 and 15 months of DMPA use. There was no significant correlation between AT III changes and changes in serum lipids. The study suggests no risk of thrombosis after 3 and 15 months of DMPA use. However, the risk of atherosclerosis appears to be possible as there were significant changes in serum lipids.