The pharmacokinetics and pharmacodynamics of dehydroepiandrosterone during use of an ethinylestradiol- and drospirenone-containing oral contraceptive. (December 2013)

• Record Type: Journal Article
• Authors: Zimmerman, Yvette; Coelingh Bennink, Herjan J. T.; Wouters, Wout; Ebes, Frieda; Fauser, Bart C. J. M.
• Is Part Of: European journal of contraception & reproductive health care. Volume 18:Number 6(2013:Dec.)
• Page Start: 489
• Page End: 500
• Publication Date: 2013-12
• Subjects: Contraception -- Periodicals; Reproductive health -- Periodicals; Generative organs, Female -- Periodicals; Contraception -- Periodicals; Reproductive Medicine -- Periodicals; 613.9
• DOI: 10.3109/13625187.2013.822061
• Languages: English
• ISSNs: 1362-5187

Abstract

<abstract> <title>Abstract</title> <p> <bold>Background</bold> Combined oral contraceptives (COCs) reduce the levels of ovarian and adrenal androgens. Co-administration of dehydroepiandrosterone (DHEA) may normalise androgen levels during COC use.</p> <p> <bold>Objective</bold> 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).</p> <p> <bold>Methods</bold> 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 μg ethinylestradiol (EE) and 3 mg drospirenone (DRSP) with and without daily co-administration of 50 mg DHEA.</p> <p> <bold>Results</bold> 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; <italic>p</italic> < 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; <italic>p</italic> < 0.001).</p> <p> <bold>Conclusion</bold> By adding DHEA to a COC the loss of adrenal and ovarian androgens can be restored.</p> </abstract>