Influence of Oral Contraceptives on Lipid Profile and Trajectories in Healthy Adolescents-Data From the EVA-Tyrol Study

J Adolesc Health. 2024 Sep;75(3):479-486. doi: 10.1016/j.jadohealth.2024.04.017. Epub 2024 Jul 10.

Abstract

Purpose: Oral contraception is one of the most popular contraceptive methods both in adults and adolescents. However, the effects of oral contraception on lipids in adolescents are not well studied.

Methods: Lipid profiles were measured and contraceptive use was assessed in 14- to 19-year-old female participants of the prospective population-based Early Vascular Ageing-Tyrol Study between 2015 and 2018, twice on average 22 months apart.

Results: For this analysis, data from 828 young women with a median age of 17.0 years were available. Of them, 317 (38%) used oral contraceptives (OCs). OC users had a slightly higher systolic and diastolic blood pressure and larger changes over time and were more likely to use cigarettes than nonusers. Total cholesterol (179.6 vs. 162.4 mg/dL), low-density lipoprotein-cholesterol (106.4 vs. 94.6 mg/dL), and triglycerides (104.0 vs. 67.0 mg/dL) were significantly higher in OC users after multivariable adjustment in linear regression models. No difference in high-density lipoprotein-cholesterol between the two groups was found. In 558 females, follow-up data were available. Those who initiated OC use had on average 15.4 mg/dL higher low-density lipoprotein-cholesterol and 36.2 mg/dL higher triglyceride level changes between baseline and follow-up than never users. Duration of OC use did not show a significant association with lipid levels and changes.

Discussion: We showed an independent association between OC use and blood lipids as well as lipid trajectories over time in a large cohort of healthy adolescents. These changes are especially relevant to consider in adolescents with other risk factors for dyslipidemia or other cardiovascular risk factors.

Keywords: Adolescent; Cardiovascular disease; Cholesterol; Contraceptive agents; Triglycerides.

MeSH terms

  • Adolescent
  • Blood Pressure / drug effects
  • Cholesterol / blood
  • Cholesterol, LDL / blood
  • Contraceptives, Oral* / administration & dosage
  • Female
  • Humans
  • Lipids / blood
  • Prospective Studies
  • Triglycerides / blood
  • Young Adult

Substances

  • Contraceptives, Oral
  • Lipids
  • Triglycerides
  • Cholesterol, LDL
  • Cholesterol