Effect of low-dose oral contraceptive on gonadotropins, androgens, and sex hormone binding globulin in nonhirsute women. Effect of low-dose oral contraceptives on androgenic markers and acne. The effect of combination therapy with metformin and combined oral contraceptives (COC) versus COC alone on insulin sensitivity, hyperandrogenaemia, SHBG and lipids in PCOS patients. Effects of a monophasic combined oral contraceptive containing nomegestrol acetate and 17β-oestradiol in comparison to one containing levonorgestrel and ethinylestradiol on markers of endocrine function Effects of seven low-dose combined oral contraceptives on sex hormone binding globulin, corticosteroid binding globulin, total and free testosterone. Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction. Effect of two oral contraceptives containing ethinylestradiol and gestodene or norgestimate upon androgen parameters and serum binding proteins. [Ovarian suppression with Diane 35/50]. Effects of oral contraceptive combinations containing levonorgestrel or desogestrel on serum proteins and androgen binding. The effect of monophasic combinations of ethinyl estradiol and norethindrone on gonadotropins, androgens and sex hormone binding globulin: a randomized trial. Combined oral contraceptive treatment of adolescent girls with polycystic ovary syndrome. Lipid profile. Correlation of biochemical markers and clinical signs of hyperandrogenism in women with polycystic ovary syndrome (PCOS) and women with non-classic congenital adrenal hyperplasia (NCAH) A randomized cross-over study on various hormonal parameters of two triphasic oral contraceptives. Comparative evaluation of the androgenicity of four low-dose, fixed-combination oral contraceptives. Clinical and hormonal effects of two contraceptives: correlation to serum concentrations of levonorgestrel and gestodene. Interrelationships between plasma testosterone, SHBG, IGF-I, insulin and leptin in prostate cancer cases and controls Different effects of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels – an association with mammographic density Placebo-controlled comparison of hormonal and biochemical effects of danazol and high-dose medroxyprogesterone acetate. Body mass index, circulating levels of sex-steroid hormones, IGF-I and IGF-binding protein-3: a cross-sectional study in healthy women. Changes in androgens during treatment with four low-dose contraceptives. [Effect of ethinyl estradiol-dienogest combination on serum androgen concentrations]. Comparative effects of oral esterified estrogens with and without methyltestosterone on endocrine profiles and dimensions of sexual function in postmenopausal women with hypoactive sexual desire. Oral contraceptive tablets containing 20 and 30 micrograms of ethinyl estradiol with 150 micrograms desogestrel. Their influence on lipids, lipoproteins, sex hormone binding globulin and testosterone. Effects on blood lipid and androgen levels of two triphasic oral contraceptives. Differential effects of estrogen-androgen and estrogen-only therapy on vasomotor symptoms, gonadotropin secretion, and endogenous androgen bioavailability in postmenopausal women. Prospective associations of androgens and sex hormone-binding globulin with 12-month, lifetime and incident anxiety and depressive disorders in men and women from the general population. Effect of oral versus transdermal steroidal contraceptives on androgenic markers. Effect of oral contraceptives on markers of hyperandrogenism and SHBG in women with polycystic ovary syndrome. The effects of spironolactone on testosterone fractions and sex-hormone binding globulin binding capacity in hirsute women Effects of an oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg dienogest on thyroid hormones and androgen parameters: conventional vs. extended-cycle use. Minimal androgenic activity of a new oral contraceptive containing norethindrone acetate and graduated doses of ethinyl estradiol. Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). Serum total and unbound testosterone and sex hormone binding globulin (SHBG) in female acne patients treated with two different oral contraceptives. Estrogen and estrogen-androgen replacement in postmenopausal women dissatisfied with estrogen-only therapy. Sexual behavior and neuroendocrine responses. The effect of 2 combined oral Contraceptives containing either drospirenone or cyproterone acetate on acne and seborrhea. Weight change and androgen levels during contraceptive treatment of women affected by polycystic ovary. Treatment of hirsutism with combined pill containing drospirenone Androgen and lipid profiles in adolescents with polycystic ovary syndrome who were treated with two forms of combined oral contraceptives. Effects of parenteral administration of estrogen and androgen on plasma hormone levels and hot flushes in the surgical menopause. Diet, physical exercise and Orlistat administration increase serum Anti-Müllerian Hormone (AMH) levels in women with polycystic ovary syndrome (PCOS) Influence of body mass index on measured and calculated androgen parameters in adult women with Hirsutism and PCOS. Resistance training increases SHBG in overweight/obese, young men. Effects of diet and metformin administration on sex hormone-binding globulin, androgens, and insulin in hirsute and obese women. Adrenal androgens and testosterone as coronary risk factors in the Helsinki Heart Study. Sex Hormone Levels and Risk of Cardiovascular Events in Postmenopausal Women
The effectiveness of a low-dose oral contraceptive ( OC ) in suppressing plasma levels of gonadotropins , ovarian , and adrenal and rogens and stimulating sex hormone-binding globulin ( SHBG ) was evaluated prospect ively in nonhirsute women . Thirty-three women ingested 35 micrograms of ethinyl estradiol and 1 mg of norethindrone beginning within day 1 to 5 of the menstrual cycle . Baseline levels of luteinizing hormone , follicle-stimulating hormone , total testosterone ( T ) , and rostenedione ( A ) , dehydroepi and rosterone sulfate ( DHEAS ) , and SHBG were obtained before ingestion of the OC and repeated after 3 , 6 and , 9 months of OC use on day 1 to 5 of the OC " cycle " . A significant suppression of gonadotropin levels is seen in nonhirsute women .  Sex hormone binding globulin is consistently stimulated by the low-dose OC . A significant suppression of T and DHEAS is observed . No change was seen in levels of A. The demonstrated effects become evident at 3 months and are maintained at 6 and 9 months Oral contraceptives ( OC ) suppress excess and rogen production ; however , different progestins in combination with low-dose estrogens produce divergent effects on sex hormone-binding globulin ( SHBG ) and testosterone that may influence clinical outcomes . This multicenter , open-label , r and omized study compared biochemical and rogen profiles and clinical outcomes associated with two OC containing the same amounts of ethinyl estradiol ( EE , 20 micrograms ) but different progestins , levonorgestrel ( LNG , 100 micrograms ) , and norethindrone acetate ( NETA , 1000 micrograms ) . Fifty-eight healthy women ( 18 - 28 years old ) received three cycles of treatment with LNG/EE ( n = 30 ) or NETA/EE ( n = 28 ) . The results showed that LNG reduced and rogen levels in three compartments -- adrenal , ovarian , and peripheral . NETA reduced only adrenal and peripheral and rogens . Despite a 2.2-fold greater relative increase in SHBG with NETA than LNG , bioavailable testosterone ( T ) was reduced by the same amount with LNG and NETA . Both treatments improved acne and were well tolerated . Low-dose OC ( EE , 20 micrograms ) are effective in reducing circulating and rogens and acne lesions without causing weight gain . Although LNG and NETA affected secondary markers differently , both OC formulations produced an equivalent decrease in bioavailable BACKGROUND Neither oral contraceptives ( COC ) nor metformin are an optimal modality for the long-term treatment of polycystic ovary syndrome ( PCOS ) . The aim of this study was to evaluate whether a combination of both is beneficial over COC monotherapy . METHODS Altogether , 30 women were included in the study and 28 finished the protocol . The patients were r and omly assigned to two groups treated with either COC ( COC group ) or COC and metformin ( 1500 mg/day ) ( METOC group ) for 6 months . Anthropometric parameters , and rogens , lipids , fasting insulin , glucose and sex hormone binding globulin ( SHBG ) concentrations were measured before and at the end of the sixth cycle of treatment . The insulin sensitivity index was evaluated using the euglycaemic clamp . RESULTS There were no significant changes in anthropometric parameters , fasting glucose or insulin sensitivity in either group . Total testosterone , free and rogen index , and rostenedione and dehydroepi and rosterone decreased and SHBG increased significantly in both groups . When comparing the effect of both treatments , only a more pronounced decrease in free and rogen index was found in the METOC group . CONCLUSIONS Adding metformin slightly modified the treatment effect of COC , causing a more significant decrease in the free and rogen index but having no additional positive impact on lipids , insulin sensitivity , SHBG or testosterone . The available data do not offer enough evidence to advocate the st and ard use of combined treatment in PCOS . Whether the combination might be beneficial for specific subgroups of patients is of further interest ABSTRACT Objectives To compare the effects of two monophasic combined oral contraceptives , containing either nomegestrol acetate/17β-oestradiol ( NOMAC/E2 ) or levonorgestrel/ ethinylestradiol ( LNG/EE ) on endocrine function , and rogens , and sex hormone-binding globulin ( SHBG ) . Methods R and omised , open-label , multi-centre trial involving 121 healthy women , aged 18–50 years old . Participants received NOMAC/E2 ( 2.5 mg/1.5 mg ) in a 24/4-day regimen ( n = 60 ) or LNG/EE ( 150 μg/30 μg ) in a 21/7-day regimen ( n = 61 ) for six cycles . The primary outcome was the change from baseline to cycle 6 in markers of adrenal and thyroid function , and rogens , and SHBG . Results Total cortisol , corticosteroid-binding globulin ( CBG ) , and thyroxine-binding globulin ( TBG ) increased from baseline in both groups , with significantly greater increases in the LNG/EE group . No relevant changes from baseline or differences between the groups were observed for thyroid-stimulating hormone ( TSH ) and free thyroxine ( T4 ) . And rogens and and rogen precursors decreased from baseline in both groups , with significantly greater decreases in the LNG/EE group ( except for free testosterone ) . A greater increase in SHBG was observed with NOMAC/E2 than with LNG/EE . Conclusions NOMAC/E2 has significantly less influence on markers of adrenal and thyroid function and and rogens than LNG/EE . The clinical relevance of these findings requires further study The effect of seven low-dose oral contraceptive preparations on sex hormone binding globulin ( SHBG ) , cortisol binding globulin ( CBG ) , total and absolute free testosterone were investigated in groups of 10 healthy volunteers . All preparations contained about the same amount of ethinylestradiol but they differed in type and /or dose of progestagen . The progestagens studied were : levonorgestrel ( LNG ; in mono- and triphasic preparations ) , norethisterone ( NET ; in monophasic preparation ) , desogestrel ( DSG ; in mono- and biphasic preparations ) and gestodene ( GSD ; in triphasic preparation ) , all 19-nortestosterone derivatives , and the anti- and rogen cyproterone acetate ( CPA ) in a monophasic preparation . Differences observed in SHBG level , which reflect the estrogen- and rogen balance , can be attributed to the intrinsic and rogenic ( or anti- and rogenic ) properties of the progestagens , and were in agreement with the results of published receptor binding studies , performed in vitro . Based on our results the following ranking ( high to low ) can be made with respect to the and rogenicity of the preparations : monophasic LNG greater than or equal to monophasic NET = triphasic LNG greater than or equal to triphasic GSD = biphasic DSG = monophasic DSG greater than monophasic CPA . An anti-estrogenic effect of the 19-nortestosterone derived progestagens can be excluded by the effect on CBG , a marker for estrogenic activity . All preparations containing a 19-nortestosterone derived progestagen , independent of their type and dose , induce a similar rise in CBG , whereas the preparation with cyproterone acetate induced an even higher CBG level . Irrespective of the effect on total testosterone , which varies between the preparations , the absolute free testosterone level decreased to a comparable degree for all preparations . ( ABSTRACT TRUNCATED AT 250 WORDS INTRODUCTION Oral contraceptives ( OCs ) have been the preferred method of birth control because of their high rate of effectiveness . OC use , however , has been associated with women 's sexual health complaints and and rogen insufficiency . OC use is associated with a decrease of and rogen ovarian synthesis and an increase in the production of sex hormone-binding globulin ( SHBG ) . There have been limited studies assessing SHBG values after discontinuation of OC use . AIM To retrospectively investigate SHBG levels before and after discontinuation of OC use . MAIN OUTCOME MEASURE Sex hormone-binding globulin values were compared at baseline , while on the OC , and well beyond the 7-day half-life of SHBG at 49 - 120 ( mean 80 ) days and > 120 ( mean 196 ) days after discontinuation of OCs . METHODS A total of 124 premenopausal women with sexual health complaints for > 6 months met inclusion /exclusion criteria . Three groups of women were defined : ( i ) " Continued-Users " ( N = 62 ; mean age 32 years ) had been on OCs for > 6 months and continued taking them ; ( ii ) " Discontinued-Users " ( N = 39 ; mean age 33 years ) had been on OCs for > 6 months and discontinued them ; and ( iii ) " Never-Users " ( N = 23 ; mean age 36 years ) had never taken OCs . RESULTS Sex hormone-binding globulin values in the " Continued-Users " were four times higher than those in the " Never-User " group ( mean 157 + /- 13 nmol/L vs. 41 + /- 4 nmol/L ; P < 0.0001 ) . Despite a decrease in SHBG values after discontinuation of OC use , SHBG levels in " Discontinued-Users " remained elevated in comparison with " Never-Users " ( N = 26 ; P < 0.0001 for > 120 days ) . CONCLUSION In women with sexual dysfunction , SHBG changes in " Discontinued-Users " did not decrease to values consistent with " Never-Users . " Long-term sexual , metabolic , and mental health consequences might result as a consequence of chronic SHBG elevation . Does prolonged exposure to the synthetic estrogens of OCs induce gene imprinting and increased gene expression of SHBG in the liver in some women ? Prospect i ve research is needed The effect of a triphasic oral contraceptive containing ethinylestradiol and gestodene ( EE/GSD ) on various serum hormonal parameters was compared with that of a monophasic formulation containing 35 micrograms ethinylestradiol and 250 micrograms norgestimate ( EE/NGM ) . Blood sample s were collected from 46 women on days 2 , 11 , and 21 of the preceding control cycle and of the third , sixth and twelfth treatment cycle . There was no significant difference in the influence on any hormonal parameter between both formulations . Both EE/GSD and EE/NGM caused a time-dependent suppression of serum dehydroepi and rosterone sulphate ( DHEA-S ) by 20 - 30 % ( p < 0.01 ) and a reduction of 5 alpha- and rostane-3 alpha , 17 beta-diol glucuronide by 50 - 60 % ( p < 0.01 ) during each treatment cycle , while and rostenedione levels were reduced by 25 % ( p < 0.01 ) . There was also a significant decrease in the levels of total testosterone by 30 - 35 % ( p < 0.01 ) and free testosterone by 60 % ( p < 0.01 ) , while sex hormone-binding globulin ( SHBG ) was increased by 200 - 240 % on days 11 and 21 ( p < 0.01 ) . During the pill-free interval the SHBG levels were reduced to a certain degree but remained elevated by 100 % as compared to the pretreatment values . The serum levels of corticosteroid-binding globulin ( CBG ) which is known to be influenced only by the estrogenic component of combination pills , increased significantly by 170 % ( p < 0.01 ) during each treatment cycle . During the pill-free interval of 7 days , the CBG levels decreased but were still elevated by 90 - 100 % as compared to the control cycle . Similarly , the serum levels of cortisol were significantly elevated by 110 - 140 % ( p < 0.01 ) during treatment with both preparations . The results demonstrate a profound suppression of and rogen levels and peripheral and rogen metabolism In this study , hormone profiles were studied using Diane 35 and Diane 50 before and after treatment for 4 - 25 months . A comparison of the hormone profiles with Diane 35 or Diane 50 should investigate , if both preparations induce complete ovarian suppression , independent of the given dose of ethinyl oestradiol .  43 patients were treated with Diane 35 and 15 women with Diane 50  over a different lengths of time -- up to a period of 25 cycles . Parallel to the determination of the hormone profiles ( luteinising hormone [ LH ] , follicle stimulating hormone [ FSH ] , prolactin , oestrone [ E1 ] , oestradiol [ E2 ] , progesterone , total testosterone [ T. T. ] , free testosterone [ F. T. ] , dehydroepi and rosterone-sulfate [ DHEA-S ] , delta-4- and rostenedione [ A. ] and sex hormone binding globulin [ SHBG ] ) , observations on the and rogen symptoms before treatment and their course during therapy were made . Moreover , the ratios of LH/FSH and E1/E2 as well as the and rogenic index , the ratio of total testosterone/SHBG were determined as control of treatment effects . The most important hormonal changes , which had been observed during a period up to two years are the following : --LH and FSH suppression -- prolactin with increasing tendency -- decrease of the total and rogens and free testosterone-- decrease of the oestrogens E1 , E2 - -increase of SHBG . The confirmation of the efficacy of the anti- and rogen/oestrogen combination was reflected by the decline of the and rogenic index in all groups . Acne and seborrhoe improved after 3 - 4 cycles ; alopecia after 8 - 9 cycles and hirsutism diminished after 3 cycles of treatment . In spite of different doses of the combined preparations with 2 mg cyproteronacetate and 0.035 or 0.050 mg ethinyloestradiol , no difference in ovarian suppression as well clinical effects could be found The effects of the oral contraceptive combinations 0.125 mg Org 2969 ( desogestrel ) ( 13-ethyl-11-methylene-18,19-dinor-17alpha-pregn-4-en-20-yn-17-ol ) + 0.05 mg ethinyloestradiol ( EE ) and 0.125 mg levonorgestrel + 0.05 mg EE on serum sex-hormone-binding globulin ( SHBG ) , ceruloplasmin , transcortin and ratio free testosterone over total testosterone ( percentage free testosterone ) and ratio free 5alpha-dihydrotestosterone over total 5alpha-dihydrotestosterone ( percentage free 5alpha-dihydrotestosterone ) were compared in healthy female volunteers . Treatment was r and omly distributed over the volunteers ; 11 women received  Org 2969 + EE  and 11 women received  levonorgestrel + EE . These combinations induced similar increases in transcortin levels ( 115 and 140 % ) and ceruloplasmin levels ( 115 and 123 % ) after 3 months of treatment . However , the combination Org 2969 + EE induced a substantial increase ( 213 % ) in SHBG capacity after 3 months of treatment , whereas a smaller increase ( 80 % ) was observed with levonorgestrel + EE . A return to pretreatment values was observed 2 months after termination of treatment for all parameters . The difference in the effects of both preparations oh SHBG was statistically significant and can be best explained by a difference in the and rogenicity of the progestogens . A good correlation was free testosterone and the reciprocal value of the percentage free 5 alpha-dihydrotestosterone . These results confirm that SHBG is the major regulator of the biologically active free and rogen fraction in women before , during and after combined oral contraceptive treatment The effects of different monophasic combinations of ethinyl estradiol and norethindrone on FSH , LH , sex hormone binding globulin , total testosterone , and rostenedione , and dehydroepi and rosterone sulfate levels in non-obese , non-hirsute women were compared . Retrospective analysis of frozen serum from a prospect i ve r and omized trial in which women received one of three oral contraceptive pills containing ethinyl estradiol 50 micrograms/norethindrone 1 mg , ethinyl estradiol 35 micrograms/norethindrone 1 mg or ethinyl estradiol 35 g/norethindrone 0.5 mg for nine cycles was conducted . Blood sample s were obtained prior to treatment and during the third , sixth and ninth pill cycles . Ethinyl estradiol 50 micrograms/norethindrone 1 mg and ethinyl estradiol 35 micrograms/norethindrone 1 mg suppressed FSH , LH , and total testosterone and increased sex hormone binding globulin to a similar degree . Ethinyl estradiol 35 micrograms/norethindrone 0.5 mg result ed in less suppression of FSH , LH , and total testosterone , but greater elevation of sex hormone binding globulin . Dehydroepi and rosterone sulfate was suppressed to a similar degree with ethinyl estradiol 35 micrograms/norethindrone 1 mg and ethinyl estradiol 35 micrograms/norethindrone 0.5 mg , but ethinyl estradiol 50 micrograms/norethindrone 1 mg result ed in the least suppression of dehydroepi and rosterone sulfate .  Ethinyl estradiol 35 micrograms/norethindrone 1 mg caused greater suppression of and rostenedione than did the other two oral contraceptives . Oral contraceptive-induced changes in gonadotropins , and rogens , and sex hormone binding globulin can be predicted by considering the relative amounts of estrogen and progestin in the pill . When combined with 1 mg of norethindrone , 50 micrograms of ethinyl estradiol did not result in greater suppression of FSH , LH , or total testosterone or in greater elevation of sex hormone binding globulin than did 35 micrograms of ethinyl estradiol The clinical signs and neuroendocrine features of adolescents with polycystic ovary syndrome ( PCOS ) resemble those found in adult women with PCOS . These adolescent patients are c and i date s for long-term treatment by one of the different therapeutic approaches that have been proposed . It is therefore essential that the treatment does not induce unfavorable metabolic effects . We investigated and compared the effects of cyproterone acetate ( CA ) and desogestrel ( D ) , as part of combined oral contraceptives ( COC ) , on lipid metabolism and hirsutism in adolescents with PCOS . Twenty-four girls with clinical signs of PCOS were recruited . They were all hyper and rogenic and euthyroid and had normal prolactin plasma levels . Non-classic congenital adrenal hyperplasia was ruled out by the ACTH stimulation test . Blood sample s were obtained for sex hormone binding globulin ( SHBG ) , total cholesterol ( TC ) , LDL cholesterol , HDL cholesterol , triglycerides ( TGs ) , apolipoproteins A-I , A-II , B , and lipoprotein ( a ) ( Lp(a ) ) measurements . After the initial examination , therapy was initiated in a r and omly selected order ( 12 and 12 patients were treated daily by 2 mg CA and 0.150 mg D , respectively , plus 0.035 and 0.030 mg ethinylestradiol , respectively ) . The degree of hirsutism and the lipid profile were reevaluated every 3 months after initiation of therapy for 1 year . Our data show that after 12 months of treatment with the D or CA COC , the Ferriman-Gallway hirsutism score decreased and TC and LDL-C increased . TGs and HDL-C were raised significantly in the CA COC group , whereas apolipoprotein A1 increased during D COC treatment . The atheromatic indices did not change . These data suggest that treatment of adolescent girls with PCOS is comparably effective with the two contraceptive formulations and that the desogestrel COC could be considered in the treatment of adolescent PCOS patients because it does not have side effects on lipid metabolism Background : Polycystic ovary syndrome ( PCOS ) is the most common cause of hyper and rogenism in women . Non-classic congenital adrenal hyperplasia ( NCAH ) is very close to PCOS . The diagnosis of hyper and rogenism is not based on the finding of decreased or increased levels of a single hormone . Objective : In our paper , we are going to test correlation between clinical signs and biochemical markers of hyper and rogenism . Material s and Methods : In this prospect i ve study , we calculated  free testosterone ( cFT ) , bioavailable testosterone ( cBT ) , free and rogen index ( FAI ) , free estrogen index ( FEI ) , total testosterone ( TT ) , sex-hormone binding globulin ( SHBG ) , estradiol ( E2 ) , dehydroepi and rosterone-sulfat ( DHEA-S ) , 17α -hydroxyprogesterone ( 17α -OHP ) , prolactin ( P ) , C-peptid and homeostasis model assessment for insulin resistance ( Homa-IR ) were measured in two groups of young untreated women with PCOS and NCAH . Results : In our research , we did not find any significant differences between PCOS and NCAH groups by age , hormonal and calculated parameters of and rogens . Waist to hip ratio ( WHP ) and body mass index ( BMI ) values were higher in the group of patients with PCOS than NCAH group . But in all patients we found positive correlation between hirsutism score and FAI , cFT , cBT , as well as we found negative correlation between hirsutism score and SHBG . We also tested hormonal and calculated parameters of and rogens between PCOS patients by upper body and lower body obesity , but we did not find any significant differences . There was not any difference by the hirsutism score in these groups either . Conclusion : In our research we found that the calculated values of cFT , cBT and FAI are helpful for determinate hirsutism score in all hirsute patients , despite of ovarian or adrenal hyper and rogenemia The effect of two triphasic oral contraceptives ( Triquilar [ TRQ ] and Trisiston [ TRS ] ) containing ethinyl estradiol ( EE ) and levonorgestrel ( LNG ) on various hormonal parameters was investigated in 26 women during a cross-over study .  TRS consisted of 0.03 mg EE + 0.05 mg LNG ( six tablets ) , 0.04 mg EE + 0.075 mg LNG ( six tablets ) , and 0.03 mg EE + 0.15 mg LNG ( nine tablets ) , whereas TRQ was different in the second phase ( five tablets ) and third phase ( 10 tablets ) . Blood sample s were taken on days 6 , 11 , 21 , and 28 of the control and washout cycles and the third treatment cycle . Both formulations inhibited ovulation reliably and decreased the serum levels of gonadotropins , free testosterone , and dehydroepi and osterone sulfate in a time-dependent manner , whereas estradiol and testosterone were already suppressed on day 6 , indicating a direct suppressive effect on ovarian steroid synthesis . Prolactin , which rose sporadically in some women , was not significantly changed . In contrast , the levels of sex hormone binding globulin , corticosteroid binding globulin , and cortisol were significantly elevated by 100 % . During the hormone-free interval of 7 days , all parameters returned at least partly to baseline . There was no significant difference between the effects of both formulations . The results suggest the possibility of a direct inhibitory effect of contraceptive steroids on ovarian steroid synthesis Changes in endogenous and rogen metabolism were compared in healthy women taking one of four low-dose modern oral contraceptives ( OCs ) . One hundred women were r and omized to ( 1 ) 35 micrograms ethinyl estradiol ( EE ) + 250 micrograms norgestimate ( Cilest ) ; ( 2 ) 20 micrograms EE + 150 micrograms desogestrel ( Mercilon ) ; ( 3 ) 30 micrograms EE + 150 micrograms desogestrel ( Marvelon ) ; or ( 4 ) 30 micrograms EE + 75 micrograms gestodene ( Femodene ) . During the luteal phase of the pretreatment cycle , body weight and blood pressure were recorded , and plasma levels of the following variables were recorded : sex-hormone-binding globulin ( SHBG ) , cortisol-binding globulin ( CBG ) , testosterone , free testosterone , dihydrotestosterone , and rostenedione , dihydroepi and rosterone sulfate ( DHEAS ) , and hydroxyprogesterone . The free and rogen index was also calculated . These variables were remeasured during the third week of OC intake and during the fourth and sixth cycles . There were no statistically significant differences in and rogenic variables among the four OCs . The DHEAS concentration decreased less with the 20 micrograms EE + desogestrel formulation compared with either 30 micrograms EE + desogesterel or norgestimate-containing formulations ( 20 % vs. 45 % ) . Concentrations of SHBG and CBG increased significantly in all four groups ( average 263 + /- 119 % and 94 + /- 26 % , respectively ) ; CBG increased less in women taking 20 micrograms EE + desogestrel ( about 75 % ) than in the other formulations ( about 100 % ) . The four modern , low-dose OCs tested had similar impacts on endogenous and rogen metabolism , yielding significant decreases in testosterone , dihydrotestosterone , and rostenedione , and DHEAS . All of these formulations may be beneficial in women with and rogen-related syndromes such as acne and hirsutism . Large studies are under way to establish which of the third-generation OCs is the least and rogenic . In vitro studies suggest that norgestimate has the least and rogenic profile Two triphasic oral contraceptives containing gestodene ( GES ) ( a new progestogen ) and levonorgestrel ( LNG ) were compared with respect to contraceptive effect , cycle control , acceptability and side effects . The serum concentrations of ingested hormones were measured together with ovarian , pituitary , and some adrenal hormones , as well as sex hormone binding globulin ( SHBG ) . The contraceptive effect and cycle control were good with both preparations , and there were only a few minor side effects . SHBG was elevated 2-fold in the LNG group and 3-fold in the GES group . The  GES concentration in serum varied more than the LNG concentration , but with correction for variations in SHBG binding , less variability in actual GES and LNG concentrations was seen . Serum levels of FSH , LH , estradiol and progesterone were all depressed with both preparations . The depression was more marked in the GES group , despite lower progestogen ingestion and similar serum concentrations . Equal decreases were found in testosterone , and rostenedione and dehydroepi and rosterone sulfate ( DHEA-S ) with both preparations Despite strong indirect evidence that and rogens stimulate prostate cancer development , data from most analytical studies on this association have been negative . To further investigate this issue , we studied the interrelationships between and rogenicity and insulin-like growth factor I ( IGF-I ) , insulin and leptin . Within a prospect i ve cohort study , we measured  testosterone , sex hormone-binding globulin ( SHBG ) and IGF-I , IGF-binding protein (IGFBP)-1 , IGFBP-3 , insulin and leptin , in plasma from 149 cases and 298 controls .  Testosterone correlated positively with SHBG , whereas testosterone and SHBG correlated inversely with IGF-I , IGFBP-3 , insulin , leptin and body mass index ( BMI ) . Indices of free testosterone showed an inverse linear correlation with leptin ( P<0.01 ) , and a strong drop in the 5th quintile of BMI . However , levels of free testosterone showed non-linear relationships over quintiles of insulin and IGF-I , with a significant increase in the second quintile of IGF-I compared with other levels . The absence of an association between plasma levels of  and rogens and prostate cancer risk in analytical studies , despite the strong indirect evidence of their tumour-stimulating effects , may reflect the complex and mostly inverse associations of and rogenicity to IGF-I , insulin and leptin which are hormones that have also been implicated as risk factors for prostate cancer Objective To compare the effects of tibolone and continuous combined hormone therapy on circulating sex steroids and their binding proteins and their relationship to  mammographic density .  Study design A prospect i ve , double-blind placebo-controlled study . A total of 166 postmenopausal women were equally r and omized to receive tibolone 2.5 mg , estradiol 2 mg/norethisterone acetate 1 mg ( E2/NETA ) or placebo . Serum analyses of sex steroids , insulin-like growth factor ( IGF-I ) and binding proteins and assessment of mammographic breast density were performed at baseline and after 6 months of treatment . Results Estrogens were markedly increased and and rogens decreased by E2/NETA . In contrast , tibolone had only a minor influence on circulating estrogens . Sex hormone binding globulin ( SHBG ) levels were reduced by 50 % , while levels of and rogens increased . Baseline values of estrone sulfate ( E1S ) , around 1.0–1.1 nmol/l , were increased to 44.7 nmol/l by E2/NETA and to only 1.7 nmol/l by tibolone ( p < 0.001 ) . Mammographic breast density displayed a negative correlation with age and body mass index and a positive association with SHBG . After 6 months there was also a negative correlation with levels of free testosterone . Conclusion We found that tibolone and E2/NETA caused distinct differences in estrogen/ and rogen status and blood levels of possible breast mitogens . The negative association between free testosterone and mammographic density could be a possible explanation for tibolone having less influence on the breast The hormonal and biochemical effects of danazol ( 600 mg a day ) and high-dose medroxyprogesterone acetate ( MPA ; 100 mg a day ) were studied in a  placebo-controlled , 6-month trial .  Serum gonadotrophins and prolactin levels did not change during danazol and MPA treatments , whereas oestradiol and progesterone levels decreased significantly in relation to placebo without any difference between danazol and MPA . Both drugs significantly suppressed the sex hormone-binding globulin level ( SHBG ) , and consequently , the free- and rogen index ( serum total testosterone nmol/l per SHBG nmol/l x 100 ) as compared with placebo , the effect of danazol being significantly stronger than that of MPA . Danazol , but not MPA , significantly increased serum aspartate aminotransferase ( ASAT ) , alanine aminotransferase ( ALAT ) and haemoglobin levels , and also thrombocyte counts , whereas MPA , but not danazol , increased the serum concentration of albumin in relation to placebo .  Serum total bilirubin , conjugated bilirubin , gamma-glutamyl transferase , creatinine , alkaline phosphatase , sodium and potassium levels and leucocyte counts remained unchanged during both treatments . Danazol and high-dose MPA did not differ from each other in their ovarian and anterior pituitary effects , while the increase in and rogenic activity induced by danazol was greater than that achieved with MPA . Danazol also had more biochemical effects than MPA . It interfered with the functions of the liver and the production of thrombocytes and haemoglobin , whereas MPA affected only albumin synthesis /release OBJECTIVE Excess weight has been associated with increased risk of cancer at several organ sites . In part , this effect may be modulated through alterations in the metabolism of sex steroids and IGF-I related peptides . The objectives of the study were to examine the association of body mass index ( BMI ) with circulating and rogens ( testosterone , and rostenedione and dehydroepi and rosterone sulfate ( DHEAS ) ) , estrogens ( estrone and estradiol ) , sex hormone-binding globulin ( SHBG ) , IGF-I and IGF-binding protein (IGFBP)-3 , and the relationship between sex steroids , IGF-I and IGFBP-3 . DESIGN AND METHODS A cross-sectional analysis was performed using  hormonal and question naire data of 620 healthy women ( 177 pre- and 443 post-menopausal ) . The laboratory measurements of the hormones of interest were available from two previous case-control studies on endogenous hormones and cancer risk . RESULTS In the pre-menopausal group , BMI was not related to and rogens and IGF-I. In the post-menopausal group , estrogens , testosterone and and rostenedione increased with increasing BMI . The association with IGF-I was non-linear , with the highest mean concentrations observed in women with BMI between 24 and 25 . In both pre- and post-menopausal subjects , IGFBP-3 did not vary across BMI categories and SHBG decreased with increasing BMI . As for the correlations between peptide and steroid hormones , in the post-menopausal group , IGF-I was positively related to and rogens , inversely correlated with SHBG , and not correlated with estrogens . In the pre-menopausal group , similar but weaker correlations between IGF-I and and rogens were observed . CONCLUSIONS These observations offer evidence that obesity may influence the levels of endogenous sex-steroid and IGF-related hormones in the circulation , especially after menopause . Circulating IGF-I , and rogens and SHBG appear to be related to each other in post-menopausal women The aim of the present study was to compare changes in the endogenous and rogen environment in healthy women while on low-dose oral contraceptives ( OCs ) . One-hundred healthy women were r and omized to receive one of four OCs during six months : 21 tablets of Cilest , Femodeen , Marvelon , or Mercilon . During the luteal phase of the pretreatment cycle , body weight and blood pressure were recorded and the following parameters were measured : sex hormone-binding globulin ( SHBG ) , corticosteroid-binding globulin ( CBG ) , testosterone ( T ) , free testosterone ( FT ) , 5 alpha-dihydrotestosterone ( DHT ) , and rostenedione ( A ) , dehydroepi and rosterone-sulphate ( DHEA-S ) and 17 alpha-hydroxyprogesterone ( 170HP ) while also the free and rogen index ( FAI ) was calculated . Measurements were repeated during the 3rd week of pill intake in the 4th and the 6th pill month . There were no differences on body mass and blood pressure with the use of the four OCs . The mean serum DHEA-S decreased significantly in all groups though less in the Mercilon group when compared to Cilest and Marvelon ( approximately 20 % vs 45 % ) . Mean serum SHBG and CBG increased significantly in all four groups approximately 250 % and 100 % , respectively . In each group CBG also increased significantly but less in women taking Mercilon ( -75 % ) as compared to the others ( -100 % ) . Current low-dose OCs were found to have similar impact on the endogenous and rogen metabolism with significant decreases of serum testosterone , DHT , A , and DHEA-S. They may be equally beneficial in women with and rogen related syndromes such as acne and hirsutism Anti and rogens or progestins with an anti and rogenic component usually have only a weak antigonadotropic activity . It is thus possible that the anti and rogenic effect on the cellular level is cancelled or at least reduced by an increased ovarian and rogen production . The aim of the four su bmi tted clinical studies of the progestin and anti and rogen dienogest alone ( 0.5 - 2 mg/day ) or of a combined regimen of ethinylestradiol ( 0.03 mg ) plus dienogest ( 2 mg ) ( EE/DNG ) was to examine the influence on the serum and rogen and SHBG concentrations as well as on the serum FSH , LH , progesterone and 17 beta-estradiol concentrations in young women . Like the progesterone derivatives , dienogest has a relatively low antigonadotropic activity . Inhibition of ovulation is mainly produced by peripheral mechanisms such as the reduction of preovulatory 17 beta-estradiol secretion .  Dienogest alone has no significant effects on the serum SHBG and and rogen concentrations . Unlike this , the combination of EE plus DNG markedly increases SHBG concentrations ( to 2.1 - 3.7 fold the basal levels ) . The decrease in serum and rogens with total testosterone ( by 17 and 40 % ) , free testosterone ( by 48 and 54 % ) and dehydroepi and rosterone sulfate ( by 51 % ) corresponds to the values shown in the literature for other oral contraceptives with modern progestins . EE/DNG does not affect the serum concentrations of 5 alpha-dihydrotestosterone ( DHT ) , although the marker of the peripheral transformation from T to DHT , and rostanediol glucuronide , is distinctly reduced ( by 38 % ) . In a double-blind comparison no differences are found between EE/DNG and a regimen combining 0.02 mg of ethinylestradiol and 0.150 mg of desogestrel . Solely the SHBG concentrations , with EE/DNG , as expected , are significantly higher . In a sequential regimen , dienogest , chlormadinone acetate and desogestrel ( progestins without binding to SHBG ) enhance the inhibitory effect of ethinylestradiol sulfonate on free testosterone , whereas norethindrone acetate and levonorgestrel ( progestins with a strong binding to SHBG ) reduce this effect of the estrogen significantly . These results exclude the possibility that the very distinct anti and rogenic effect of dienogest on a cellular level is neutralised or reduced by an increased systemic supply of and rogen OBJECTIVE In some women , a decline in sexual interest accompanies a relative and rogen insufficiency after menopause . We sought to characterize the hormonal effects of the combination of oral esterified estrogens and methyltestosterone and to investigate whether this regimen improves hypoactive sexual desire . DESIGN Double-blind r and omized trial . SETTING Healthy volunteers in a multicenter research environment . PATIENT(S ) Postmenopausal women taking estrogen therapy who were experiencing hypoactive sexual desire . INTERVENTION(S ) 4 months of treatment with 0.625 mg of esterified estrogens ( n = 111 ) or the combination of 0.625 mg of esterified estrogens and 1.25 mg of methyltestosterone ( n = 107 ) . MAIN OUTCOME MEASURES Baseline and end-of- study measurements of total and bioavailable testosterone and sex hormone-binding globulin ( SHBG ) , and mean change in level of sexual interest or desire as rated on the Sexual Interest Question naire . RESULT ( S ) Treatment with the combination of esterified estrogens and methyltestosterone significantly increased the concentration of bioavailable testosterone and suppressed SHBG . Scores measuring sexual interest or desire and frequency of desire increased from baseline with combination treatment and were significantly greater than those achieved with esterified estrogens alone . Treatment with the combination was well tolerated . CONCLUSION ( S ) Increased circulating levels of unbound testosterone and suppression of SHBG provide a plausible hormonal explanation for the significantly improved sexual functioning in women receiving the combination of esterified estrogen and methyltestosterone The effect of two oral contraceptive ( OC ) pills , both containing 150 micrograms of desogestrel , but with 20 ( Mercilon ) or 30 micrograms ( Marvelon/Desolett ) of ethinyl estradiol on plasma levels of lipids , lipoproteins and sex hormone binding globulin ( SHBG ) , total and free testosterone were compared in a double-blind , r and omized , two-center study in a total of 60 women over one year . A significant rise with Marvelon but not with Mercilon was seen in total cholesterol , HDL cholesterol , HDL-3 and apolipoprotein B , whereas LDL cholesterol decreased with Mercilon only . These effects result ed in significant differences between the two groups in the magnitude of responses in all these parameters except HDL-3 . HDL-2 , apolipoprotein A-1 and total phospholipids were elevated with both pills after treatment and with no difference in the degree of response between groups . The HDL/LDL cholesterol ratio tended to increase in both groups and that of apolipoproteins A-1/B in the women on Mercilon . Total triglycerides increased in both groups , but more in the women on Marvelon . Total testosterone decreased , particularly in the Marvelon group , whereas the two pills caused a similar increase in SHBG and decrease in free testosterone . It is concluded that the direction of changes in plasma lipids and lipoproteins with both these pills may as a whole be interpreted as beneficial , and that the differences in effect on LDL cholesterol and apolipoprotein B may suggest a slightly advantageous effect of Mercilon in this aspect . However , the clinical significance of these changes is uncertain . The results indicate a lack of and rogenicity of both pills At Hospital Saint-Louis in Paris France physicians compared data on 34 women using a levonorgestrel triphasic oral contraceptive ( OC ) with data on 32 women using a norgestimate triphasic OC  to examine the triphasic OCs effects on blood lipids and and rogen levels . They also compared post-OC blood lipids and and rogen levels with baseline blood lipids and and rogen levels . 47 % of all subjects smoked . After 6 cycles neither triphasic OC caused a significant difference in low density lipoprotein ( LDL ) cholesterol levels or in triglyceride levels . High density lipoprotein ( HDL ) levels in women using the norgestimate OC were significantly higher than in those using the levonorgestrel OC ( p = .001 ) . Accordingly the OCs had a significant effect on the LDL/HDL ratio . Levels of HDL subfractions ( HDL-2 and HDL-3 ) were also significantly higher in the norgestimate OC group than in the levonorgestrel OC group ( p < .01 ) . Women using the norgestimate OC had a significant increase in apolipoproteins A-1 and 1 - 2 after 6 cycles ( 12.7 % and 15.8 % respectively ; p = .001 and .0001 respectively ) . Neither triphasic OC affected a greater increase in sex hormone binding globulin ( SHBG ) levels than did the levonorgestrel OC ( 163 % vs. 72 % ; p = .0005 ) . It reduced the free testosterone level by 40 % . The levonorgestrel OC reduced it by 30 % but neither change was significant . Neither OC had an effect on body weight or blood pressure . These findings showed a trend toward lower and rogenicity with the norgestimate OC . The norgestimate OC may be beneficial since it was linked with significant increases in all HDL subfractions and SHBG OBJECTIVE To investigate somatic symptom relief , gonadotropin secretion , and endogenous and rogen bioavailability ( protein-bound and free ) during 3 months of estrogen- and rogen therapy or matched estrogen-only replacement therapy . DESIGN Ninety-three naturally menopausal out patients with 6 or more months of amenorrhea , who were experiencing mild-to-moderate vasomotor symptoms , were r and omized to receive one of five treatments : oral esterified estrogens ( 0.625 mg or 1.25 mg ) , oral esterified estrogens combined with methyltestosterone ( 0.625 mg combined with 1.25 mg methyltestosterone or esterified estrogens 1.25 mg combined with 2.5 mg methyltestosterone ) , or placebo for 12 weeks . All treatments were preceded by a 4-week placebo lead-in period . RESULTS Patients receiving the lower dose of estrogen- and rogen therapy had fewer somatic menopausal symptoms than patients receiving the lower dose estrogen ( 0.625 mg ) , and they experienced somatic symptom relief similar to those patients receiving the higher dose of estrogen ( 1.25 mg ) . Significantly greater luteinizing hormone suppression ( p < or = 0.03 ) occurred in estrogen- and rogen groups compared to estrogen groups , suggesting that added and rogen might mediate a more pronounced negative feedback on the hypothalamic-pituitary axis . Sex hormone-binding globulin increased significantly in both estrogen-treated groups ( p < or = 0.01 ) , whereas decreases occurred in both estrogen- and rogen groups ( p < or = 0.006 ) . The higher dose estrogen-only preparation significantly reduced and rostenedione ( p < or = 0.01 ) and dehydroepi and rosterone sulfate ( p < or = 0.005 ) . CONCLUSION The extent of relief with lower dose estrogen- and rogen therapy was similar to higher dose estrogen-only treatment . The greater efficacy of combination therapy on somatic symptoms could be mediated by the same mechanism responsible for the suppressive effects of estrogen- and rogen therapy on luteinizing hormone secretion . The marked differences in circulating levels of sex hormone building globulin , which were increased by estrogen and decreased by estrogen- and rogen , and the result ing impact on bioavailable and rogens and estrogens could also explain the differential somatic relief with both treatments . Endogenous adrenal and rogens were lower in women treated with esterified estrogens 1.25 mg/day , suggesting that estrogen therapy can produce a significant hypo and rogenic state by inhibiting production or accelerating clearance of adrenal and rogens BACKGROUND Findings on associations of and rogens and sex hormone-binding globulin ( SHBG ) with  anxiety and depressive disorders in the general population remain inconclusive . METHODS We used data of n = 993 men and n = 980 women from the Study of Health in Pomerania ( SHIP , a prospect ive-longitudinal general population study from northeastern Germany ) .  Immunoassay-measured serum concentrations of total testosterone , and rostenedione and SHBG  were assessed when participants were aged 20 - 80 . 12-month , lifetime and incident DSM-IV anxiety and depressive disorders were assessed with the DIA-X/M-CIDI at 10-year follow-up , when participants were aged 29 - 89 . Logistic regressions were adjusted for age , smoking , alcohol consumption , physical activity , waist circumference , hypertension and oral contraceptive use ( women only ) at baseline and follow-up interval . RESULTS In men and women , and rogens and SHBG were not associated significantly with incident anxiety and depressive disorders . In men , higher total testosterone predicted any 12-month ( OR = 1.46 ) and lifetime ( OR = 1.34 ) anxiety disorder , lifetime social phobia ( OR = 2.15 ) , and 12-month ( OR = 1.48 ) and lifetime ( OR = 1.39 ) specific phobia , but neither 12-month nor lifetime depression . Moreover , and rostenedione in men interacted with age in predicting lifetime anxiety disorders ( OR = 0.98 ) : Higher and rostenedione more strongly predicted lifetime anxiety in younger vs. older men . These findings , however , did not survive correction for multiple testing . In women , and rogens and SHBG were not associated significantly with 12-month and lifetime anxiety and depressive disorders . LIMITATIONS The follow-up period was relatively long and other factors might have affected the examined associations . CONCLUSIONS Higher serum total testosterone in men and and rostenedione in younger men may relate to an increased risk of anxiety disorders OBJECTIVE The purpose of this study was to compare biochemical and rogen profiles in women treated with the contraceptive patch versus an oral contraceptive ( OC ) . STUDY DESIGN Twenty-four healthy women were r and omly assigned to receive 3 cycles of either the contraceptive patch ( ethinyl estradiol [ EE ] 20 microg/d and norelgestromin 150 microg/d ) or OC ( EE 35 mug and norgestimate 250 microg ) . Blood sample s were taken at baseline and end of treatment . Serum levels of sex hormone-binding globulin ( SHBG ) , total testosterone ( T ) , and rostenedione ( A ) , dehydroepi and rosterone sulfate ( DHEAS ) , dihydrotestosterone ( DHT ) , and 3alpha- and rostanediol glucuronide ( 3alpha-diol G ) were quantified by immunoassay methods ; free T was calculated . The paired t and Student t tests were used for statistical analysis . RESULTS Nineteen women completed the study ( patch , n = 10 ; OC , n = 9 ) . Despite a 1.6-fold relative increase in SHBG levels with the patch versus OC ( 449 % vs 274 % , P = .03 ) , free T decreased equally in both groups ( patch 60 % , P < .0001 ; OC 59 % , P < .0001 ) . DHEAS decreased by 26 % in the patch group ( P < .01 ) and 32 % in the OC group ( P < .001 ) . 3alpha-diol G was reduced by 52 % in the patch group ( P < .0001 ) and 51 % in the OC group ( P < .0001 ) . In addition , the OC was associated with significant decreases in A and DHT . CONCLUSION The contraceptive patch had an effect comparable to the OC on several key and rogenic markers . Given these biochemical findings , the contraceptive patch has significant potential as a therapeutic agent for disorders of and rogen excess BACKGROUND This r and omized study 's aim was to compare the effect of four oral contraceptives ( OCs ) containing 30 mcg of ethinylestradiol ( EE ) and different progestogens [ drospirenone , ( DRSP ) , chlormadinone acetate ( CMA ) , desogestrel ( DSG ) , gestodene ( GSD ) ] on biochemical and hormonal parameters of hyper and rogenism and sex hormone-binding globulin ( SHBG ) in women with polycystic ovary syndrome ( PCOS ) . STUDY DESIGN Forty women with PCOS ( age 16 - 35 years ) were recruited and r and omly assigned to one of four treatment groups of 10 women each , treated , respectively , with 3 mg DRSP/30 mcg EE ( Yasmin , Bayer Shering ) , 2 mg CMA/30 mcg EE ( Belara , Grunenthal ) , 75 mcg GSD/30 mcg EE ( Minulet , Wyeth Lederle ) and 150 mcg DSG/30 mcg EE ( Practil 21 , Organon Italia ) . Blood sample s were obtained on day 6 - 8 of the control cycle and day 6 - 8 of the third treatment cycle for assay of the following hormones : and rosteredione ( A ) , total testosterone ( T ) , free T , SHBG , dehydroepi and rosterone sulphate ( DHEAS ) . RESULTS In all groups , mean concentrations of free T , total T and A dropped by 40 - 60 % , and concentrations of DHEAS dropped by 20 - 50 % . Formulations with DRSP and CMA caused a greater reduction of and rogens and a progressive increase in serum concentrations of SHBG than those with DSG and GSD . CONCLUSIONS Clinical studies need to be performed to determine effects of these OCs upon clinical signs of hyper and rogenism This study explored the effect of the anti- and rogen spironolactone on sex-hormone binding globulin ( SHBG ) and the distribution of circulating testosterone ( T ) into various free and bound fractions in seven women with hirsutism assessed before and then monthly for three months on a regimen of spironolactone , 100 mg bid as the sole therapeutic agent . Blood sample s were taken at each assessment time for a battery of and rogen parameters and serum T fractions studies . None of the women were judged obese based upon body mass index values . After three months of spironolactone therapy , there was little change in the hirsutism index , and measurement of serum T , and rostenedione , DHEA-S and 17ß-estradiol showed no significant changes , the same occurring with SHBG-binding capacity . However , there was a shift in the distribution of circulating T , with a decrease in SHBG-bound T and an increase in albumin-bound and free T ( non-SHBG-bound fractions ) . As previous reports suggest that non-SHBG-bound fractions represent bioavailable fractions , the current data suggests that T fraction studies may not be clinical ly useful parameters of hyper and rogenism in women receiving anti and rogen therapy BACKGROUND This study was conducted to investigate the effects of an oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg dienogest on thyroid hormones and and rogen parameters . STUDY DESIGN Thyroid and and rogen parameters were measured in 59 women treated with a monophasic combined oral contraceptive containing 30 mcg ethinyl estradiol and 2 mg dienogest ( EE/DNG ) either conventionally ( 13 cycles with 21 days of treatment+7 days without hormones ) or according to an extended-cycle regimen ( four extended cycles with 84 days of continuous administration of  EE/DNG  , followed by a hormone-free interval of 7 days ) .  Blood sample s were taken on Days 21 - 26 of the preceding control cycle and on Days 19 - 21 of the 3rd and 13th conventional cycle , or on Days 82 - 84 of the first and fourth extended cycle . RESULTS At both time points , the serum concentrations of thyroxine-binding globulin were elevated by about 65 % in both treatment regimens . Likewise , both groups showed an increase in total triiodothyronine ( T3 ) and total thyroxine ( T4 ) by 30 - 40 % , and no change in free T4 . Until the 12th month of conventional treatment , the level of free T3 remained unchanged but decreased slightly during the extended-cycle regimen . In both groups there was a rise of sex hormone-binding globulin by 210 - 230 % after 3 months and by 220 - 250 % after 12 months . The levels of total testosterone were reduced by about 40 % and those of free testosterone by 55 - 65 % after 3 and 12 months . CONCLUSION The results suggest that , during conventional and extended-cycle treatment with EE/DNG , a steady state in the effects on thyroid hormones and and rogen parameters was reached within 3 months and that the changes in the various hormonal parameters did not substantially differ between conventional and extended-cycle regimen The pharmacokinetics and and rogenic activity of Estrostep , a new oral contraceptive providing low-dose estrogen in a graduated sequence with a constant dose of progestin , were characterized in an open-label , nonr and omized study in 17 normally cycling women treated for three cycles with Estrostep .  Women received 1 mg of norethindrone acetate daily combined with 20 microg of ethinyl estradiol daily for the first 5 days ( 1/20 ) , 30 microg of ethinyl estradiol daily for the next 7 days ( 1/30 ) , and 35 microg of ethinyl estradiol daily for 9 days ( 1/35 ) . No medication was given for 7 days in each cycle to allow for withdrawal bleeding . Serial blood sample s for the measurement of ethinyl estradiol and norethindrone concentrations were collected on days 5 , 12 , and 21 of the third treatment cycle for the 1/20 , 1/30 , and 1/35 dose , respectively . Sex hormone-binding globulin ( SHBG ) and free testosterone were measured at baseline , on day 1 of cycles 2 and 3 ( SHBG only ) , and on days 5 , 12 , and 21 of cycle 3 . Mean steady-state plasma ethinyl estradiol and norethindrone concentrations increased over cycle 3 . The increases in ethinyl estradiol concentrations were proportional to dose . The increases in norethindrone concentrations were related to ethinyl estradiol-dependent increases in SHBG concentrations , which were 218 % , 253 % , and 296 % of baseline values on days 5 , 12 , and 21 , respectively . Mean plasma free testosterone concentrations decreased 47 % , 60 % , and 64 % below baseline on days 5 , 12 , and 21 of cycle 3 , respectively . Graduated ethinyl estradiol doses combined with a constant norethindrone acetate dose progressively increase SHBG and decrease free testosterone , which overrides any theoretic concerns of and rogenic activity of norethindrone acetate . Although true and rogenic activity can be determined only by assessing endpoints such as acne , hirsutism , and lipids in large controlled trials , the observed changes in circulating SHBG and free testosterone concentrations indicate that Estrostep has little , if any , intrinsic and rogenic activity BACKGROUND Contrasting etiologic hypotheses about the role of endogenous sex steroids in breast cancer development among premenopausal women implicate ovarian and rogen excess and progesterone deficiency , estrogen excess , estrogen and progesterone excess , and both an excess or lack of adrenal and rogens ( dehydroepi and rosterone [ DHEA ] or its sulfate [ DHEAS ] ) as risk factors . We conducted a case-control study nested within the European Prospect i ve Investigation into Cancer and Nutrition cohort to examine associations among premenopausal serum concentrations of sex steroids and subsequent breast cancer risk . METHODS  Levels of DHEAS , ( Delta4- ) and rostenedione , testosterone , and sex hormone binding globulin ( SHBG )  were measured in single prediagnostic serum sample  s from 370 premenopausal women who subsequently developed breast cancer ( case patients ) and from 726 matched cancer-free control subjects .  Levels of progesterone , estrone , and estradiol  were also measured for the 285 case patients and 555 matched control subjects who had provided information about the day of menstrual cycle at blood donation . Conditional logistic regression models were used to estimate relative risks of breast cancer by quartiles of hormone concentrations . All statistical tests were two-sided . RESULTS Increased risks of breast cancer were associated with elevated serum concentrations of testosterone ( odds ratio [ OR ] for highest versus lowest quartile = 1.73 , 95 % confidence interval [ CI ] = 1.16 to 2.57 ; P(trend ) = .01 ) , and rostenedione ( OR for highest versus lowest quartile = 1.56 , 95 % CI = 1.05 to 2.32 ; P(trend ) = .01 ) , and DHEAS ( OR for highest versus lowest quartile = 1.48 , 95 % CI = 1.02 to 2.14 ; P(trend ) = .10 ) but not SHBG . Elevated serum progesterone concentrations were associated with a statistically significant reduction in breast cancer risk ( OR for highest versus lowest quartile = 0.61 , 95 % CI = 0.38 to 0.98 ; P(trend ) = .06 ) . The absolute risk of breast cancer for women younger than 40 followed up for 10 years was estimated at 2.6 % for those in the highest quartile of serum testosterone versus 1.5 % for those in the lowest quartile ; for the highest and lowest quartiles of progesterone , these estimates were 1.7 % and 2.6 % , respectively . Breast cancer risk was not statistically significantly associated with serum levels of the other hormones . CONCLUSIONS Our results support the hypothesis that elevated blood concentrations of and rogens are associated with an increased risk of breast cancer in premenopausal women Serum total an unbound testosterone ( T ) and sex hormone binding globulin ( SHBG ) levels were studied in fifty-four female acne patients before treatment and during the treatment by two different oral contraceptives , the other containing 0.150 mg desogestrel plus 0.03 mg EE and the other 0.150 mg levonorgestrel plus 0.03 mg EE .  Pretreatment values were abnormal in 57 % of the patients . A borderline significant correlation between the severity of acne and SHBG was found . Ater six months ' treatment a 250 % increase in SHBG was seen in desogestrel/EE group and no significant change in SHBG in levonorgestrel/EE group . However , at the same time serum free testosterone fell 60 % in both treatment groups . SHBG can not be the only regulator of serum free testosterone . Acne improved significantly in both treatment groups . It is likely that the improvement was in connection with the free testosterone decrease and the improvement was better in the desogestrel/EE group where also SHBG elevation was seen OBJECTIVE To investigate the efficacy of esterified estrogens alone and combined with oral and rogen on sexual function and menopausal symptoms in postmenopausal women . STUDY DESIGN Twenty postmenopausal women dissatisfied with their estrogen or estrogen-progestin therapy volunteered to enter a double-blind , r and omized trial in which they received either oral esterified estrogens or esterified estrogens + and rogen for eight weeks after a single-blind , placebo , lead-in period . Sexual function was assessed with a question naire used in the Yale midlife survey , and plasma levels of estradiol , estrone , sex hormone binding globulin ( SHBG ) and beta-endorphin were measured at two- to four-week intervals . RESULTS Estrogen- and rogen therapy significantly improved sexual sensation and desire after four and eight weeks of double-blind treatment in comparison to previous estrogen therapy and postplacebo baseline assessment s. Plasma levels of estradiol and estrone increased significantly in all patients as compared to the postplacebo baseline and decreased in comparison to circulating estrogen concentrations on previous therapy . Relative proportions of free and bound steroid hormone exhibited contrasting shifts during estrogen and estrogen- and rogen therapy .  SHBG increased in the estrogen group and decreased in the estrogen- and rogen group , leading to lower amounts of free and rogens during estrogen therapy and increased free and rogen levels during estrogen- and rogen therapy . Since proportions of free ( bioavailable ) ovarian steroids would correlate inversely with plasma protein binding capacity , the beneficial effects of oral estrogen- and rogen therapy on sexual sensation and desire may be due either to the administered and rogen or to the increased availability of endogenous and exogenous and rogens , particularly in the central nervous system . CONCLUSION Sexual desire , satisfaction and frequency in postmenopausal women taking hormonal therapy were improved significantly by combined estrogen- and rogen therapy but not by estrogen or estrogen-progestin therapy .  Sexual function improved with estrogen- and rogen therapy even though circulating estrogen levels were lower than those measured during previous estrogen therapy . This leads to the conclusion that and rogens play a pivotal role in sexual function but that estrogens are not a significant factor determining levels of sexual drive and enjoyment A new oral contraceptive has been developed that contains a unique progestogen , drospirenone ( DRSP ) , and that has both anti and rogenic and antimineralocorticoid activity . Our objective was to compare the effect of 30 microg ethinyl estradiol (EE)/3 mg DRSP ( EE/DRSP ; Yasmin , Schering AG , Berlin , Germany ) with that of 35 microg EE/2 mg cyproterone acetate ( EE/CPA ; Diane-35 , Schering AG , Berlin , Germany ) on mild-to-moderate cases of acne . Diane-35 is used worldwide ( it is not on the market in the United States and Japan ) as a hormone treatment for acne , with additional contraceptive benefits . This multicenter , double-blind , r and omized study was completed over 9 treatment cycles . A total of 128 women with mild-to-moderate facial acne , with or without seborrhea and /or hirsutism , were r and omized . Treatment with either EE/DRSP or EE/CPA was assigned in a 2:1 ratio . Acne lesions , sebum production , and hair growth on the upper lip , chin , and chest were assessed , as well as levels of total and free testosterone , and rostenedione , dehydroepi and rosterone sulfate ( DHEAS ) , sex hormone-binding globulin ( SHBG ) , and luteinizing hormone ( LH ) . At study completion , dermatologists , gynecologists , and subjects gave their overall assessment of the effect of treatment on acne . After 9 treatment cycles , the median total acne lesion count was reduced markedly by 62.5 % in the EE/DRSP group and 58.8 % in the EE/CPA group . A comparison of the 2 groups revealed that EE/DRSP was at least as effective as EE/CPA . Both preparations also reduced sebum production and hair growth on the upper lip and chin . A 3-fold increase in the levels of SHBG was observed in both treatment groups , and levels of and rogens and LH decreased . Treatment differences were not seen . Subjective evaluation of the effect of treatment on facial acne by dermatologists , gynecologists , and the subjects themselves indicated an excellent or good improvement for most subjects in both groups . EE/DRSP has been shown to be as effective for treating mild-to-moderate acne as a preparation containing EE/CPA . This new preparation may provide useful hormone therapy for women with and rogen-dependent disorders who also require contraception OBJECTIVE The aim of this study was to investigate the effect of oral contraceptive Diane 35 ( ethinylestradiol + cyproteroneacetate EE/CPA ) which is widely used in the treatment of PCOS in Europe , on body weight , lipid levels and endocrine parameters in non-obese women with PCOS . SUBJECTS AND METHODS Nineteen PCOS women were examined in the early follicular phase of menstrual cycle , blood sample s for the estimation of cholesterol ( C ) , HDL cholesterol ( HDL-C ) , triglycerides ( TG ) , testosterone ( T ) , and rostenedione ( A ) , dehydroepi and rosterone sulfate ( DHEAS ) and sex hormone binding globulin ( SHBG ) were taken before the start of treatment with Diane 35 and again after 7 + /- 3.8 months of treatment with Diane 35 .  Body weight ( W ) was recorded at the time of both examinations . RESULTS After the treatment with Diane 35 the levels of W ( p<0.05 ) , total C ( p<0.05 ) , TG ( p<0.004 ) and SHBG ( p<0.0001 ) increased significantly . In addition , significant negative correlation between SHBG levels before treatment and increase of W after Diane 35 was found ( r= -0.56 ; p<0.02 ) . Increase of W correlated negatively with T before treatment ( r= 0.58 ; p < .02 ) and positively with the change in T level after treatment ( r=0.50 ; p<0.05 ) . CONCLUSIONS Increase of body weight in a significant number of PCOS-affected women was seen after treatment with Diane 35 and it is assumed to blunt ameliorating effects of this treatment on and rogen levels . Considering our findings , we conclude that the treatment with CPA/EE can result in significant weight gain ameliorating positive effects of the treatment on and rogen levels . These findings could underline the necessity of the finding new therapeutical options for PCOS , besides contraception . Studies concerning body composition during contraceptive treatment in PCOS would be also useful in the future The aim of the present study was to evaluate the biochemical and clinical effects of the combined pill consisting of ethinyl estradiol ( EE ) and drospirenone ( DRSP ) in hirsute patients . Fifty-two adolescents or young women from Greece were treated with 30 μg EE and 3 mg DRSP for 1 year . Hirsutism was evaluated by the Ferriman – Gallway ( FG ) score in the initial visit and at 3 , 6 and 12 months . Follicle-stimulating hormone , luteinizing hormone , etradiol , free and total testosterone ( T ) , sex hormone-binding globulin ( SHBG ) , and rostenedione and dehydroepi and rosterone sulfate were determined at the same intervals . Hirsutism improved and FG scores reduced to 77.4 % , 67.2 % and 51.8 % at 3 , 6 and 12 months , respectively . Plasma SHBG levels rose , while free and total T levels reduced from the third month onwards . In conclusion , the EE/DRSP pill improves hirsutism in women via anti and rogenic and antimineralocorticoid action . The biochemical manifestations of hyper and rogenism are also improved OBJECTIVE To compare the effects of cyproterone acetate and desogestrel , as part of combined oral contraceptives , on lipid metabolism and  hirsutism of adolescents with polycystic ovary syndrome ( PCOS ) . DESIGN Prospect i ve r and omized clinical trial . SETTING Outpatient gynecology clinic ( referral center ) of a university . PATIENT(S ) Twenty-eight adolescent girls with clinical and biological hyper and rogenism and six or less menses during the past 12 months . INTERVENTION(S ) Group A ( n = 14 ) received 0.15 mg of desogestrel plus 0.030 mg of ethinyl estradiol daily . Group B ( n = 14 ) received 2 mg of cyproterone acetate plus 0.035 mg of ethinyl estradiol daily . Treatment was given for 21 days followed by a 7-day rest for a period of 12 months . MAIN OUTCOME MEASURE(S ) Hirsutism and lipid profile were evaluated before initiation and at 3 , 6 , 9 , and 12 months of treatment . And rogen profile was evaluated before and at 12 months of treatment . RESULT ( S ) A significant decline of the Ferriman-Gallway hirsutism score was observed from the sixth month of therapy in both groups . During therapy , the levels of testosterone , free testosterone , Delta(4)- and rostenedione , and 17OH-progesterone decreased significantly , whereas sex hormone-binding globulin ( SHBG ) increased significantly in both groups . The level of total cholesterol and low density lipoprotein ( LDL ) cholesterol increased significantly , whereas high density lipoprotein ( HDL ) cholesterol and apolipoprotein A-I increased significantly from the third month of therapy in both groups . Total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios remained unchanged . The levels of triglycerides increased significantly in the cyproterone acetate-treated group after the third month . CONCLUSION ( S ) Treatment of adolescent girls with PCOS with the two studied formulations is comparably effective in decreasing hirsutism and and rogen levels . Both combined oral contraceptives are associated with an increase of total cholesterol , LDL cholesterol , and HDL cholesterol levels and no change of the total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratios . Treatment with the cyproterone acetate combined oral contraceptive is associated with a tendency toward increasing the levels of triglycerides In a prospect i ve , double-blind , crossover study , it was found that surgically menopausal women who received an estrogen drug alone and those who were given a combined estrogen- and rogen preparation  reported a significantly reduced frequency of hot flushes compared to a placebo group ( p less than 0.01 ) coincident with their higher total plasma estrogen levels ( p less than 0.01 ) . The administration of testosterone alone , however , was ineffective in alleviating hot flushes , even though these patients had plasma estrogen values that were not different from those of women with intact ovaries . It was proposed that , in women with very low levels of endogenous estrogens , changes in sex hormone-binding globulin ( SHBG ) concentrations induced by exogenous testosterone may reduce the amount of non-SHBG-bound estrogens , thereby obviating estrogenic effects on hot flushes The present study investigates the combined effect of diet , physical exercise and Orlistat for 24 weeks , on serum Anti-Müllerian Hormone ( AMH ) levels in overweight and obese women with polycystic ovary syndrome ( PCOS ) and in overweight and obese controls . Sixty-one ( 61 ) selected women with PCOS and 20 overweight and obese controls followed an energy-restricted diet , physical exercise plus Orlistat administration ( 120 mg , 3 times per day ) for 24 weeks . At baseline , week 12 and week 24 , serum levels of AMH , FSH , LH , PRL , and rogens , sex hormone – binding globulin ( SHBG ) , glucose , and insulin were measured and Free And rogen Index ( FAI ) and Insulin Resistance ( IR ) indices were calculated . In PCOS women , serum AMH levels increased after 12 and 24 weeks of treatment . After 12 weeks LH and SHBG were increased , while Testosterone decreased . After 12 and 24 weeks , FAI was decreased and all indices of IR were significantly improved . We concluded that in overweight and obese women with PCOS Orlistat administration , combined with diet and physical exercise , for 24 weeks , result ed in significant weight loss , improvement of hyper and rogenism and insulin sensitivity , and increased serum AMH levels There is growing evidence that obesity in women lead to a more severe form of hyper and rogenism and other endocrine abnormalities which may have some health implication s later in life . Obese females are at higher risk for metabolic syndrome due to severe hyper and rogenemia . Calculated values for free testosterone are equivalent to those obtained by equilibrium dialysis , which is one of the reference measurement procedures ( RMP ) for estimation of free testosterone and may be capable of replacing values estimated using RMP 's . For adult women correlations of body mass index ( BMI ) with calculated free ( cFT ) and bioavailable testosterone ( cBT ) are still rare , while these data are reported for peripubertal and adolescent girls . In this study we aim ed to investigate the association between BMI and different and rogen parameters ( including calculated free and bioavailable testosterone , free and rogen index , and sex hormone-binding globulin [ SHBG ] ) in adult women with Hirsutism and with PCOS . In hirsute women with BMI > or = 25 kg/m2 measured total testosterone ( TT ) was significantly higher , SHBG was significantly lower and the calculated and rogen parameter ( FAI , cFT and cBT ) were significantly higher compared to women with BMI < 25 kg/m2 . In PCOS women with BMI > or = 25 kg/m2 TT was significantly higher , SHBG was significantly lower and the calculated and rogen parameter ( FAI , cFT and cBT ) were also significantly higher compared to women with BMI < 25 kg/m2 . In both the Hirsutism and PCOS-group there was a positive correlation between BMI and TT , cFT , and cBT , while BMI was negatively correlated with SHBG . In summary , in adult women with Hirsutism and PCOS obesity is associated with increased levels of TT and decreased levels of SHBG result ing in significant elevated calculated free and bioavailable testosterone levels . Obesity might lead to a more severe form of hyper and rogenism with elevated calculated free and bioavailable testosterone in the study population OBJECTIVE Evidence suggests that SHBG affects glycemic control , predicts both T2D and metabolic syndrome , and is low in obese subjects . We sought to determine if resistance exercise training ( RT ) can increase sex hormone-binding globulin ( SHBG ) and ameliorate levels of related steroid hormones in overweight/obese , sedentary young men . MATERIAL S/ METHODS 36 participants ( BMI 31.4 kg/m(2 ) , age 22 years ) were r and omized into an RT ( 12 weeks of training , 3/week ) or control group ( C , 12 weeks no training ) , and assessed for changes in SHBG , cortisol , testosterone , free testosterone ( FT ) and free and rogen index ( FAI ) . In addition , body composition and oral glucose tolerance testing was performed . RESULTS 12 weeks of RT  increased SHBG ( P=0.01 ) and decreased FAI ( P<0.05 ) and cortisol ( P<0.05 ) compared to C. FT decreased in RT ( P=0.01 ) . Total testosterone did not change in either group . These changes were noted without weight loss , and in concert with increases in lean body mass ( P=0.0002 vs C ) and decreases in glucose area under the curve ( AUC ) ( P=0.004 ) , insulin AUC ( P=0.03 ) , and total ( P=0.002 ) and trunk ( P=0.003 ) fat mass in RT . CONCLUSION In overweight/obese young men , RT increases SHBG and lowers FAI in obese young adult men Evidence suggests that hyperinsulinemic insulin resistance may increase serum levels of ovarian and rogens and reduce sex hormone-binding globulin ( SHBG ) levels in humans . The present study was conducted to assess the effect of administration of the biguanide metformin , a drug commonly used in the treatment of diabetes mellitus , on and rogen and insulin levels in 24 hirsute patients . The patients selected for the study were obese , with a body mass index higher than 25 kg/m2 and high fasting insulin ( > 90 pmol/L ) and low SHBG levels ( < 30 nmol/L ) . All patients were given a low calorie diet ( 1500 Cal/day ) and r and omized for either metformin administration at a dose of 850 mg or a placebo , twice daily for 4 months , in a double blind study . In the placebo group , diet result ed in a significant decrease in body mass index ( 30.8 + /- 1.0 vs. 32.7 + /- 1.5 kg/m2 ; P < 0.0001 ) , fasting insulin ( 127 + /- 11 vs. 156 + /- 14 pmol/L ; P < 0.01 ) , non-SHBG-bound testosterone ( 0.19 + /- 0.02 vs. 0.28 + /- 0.03 nmol/L ; P < 0.02 ) , and rostenedione ( 5.8 + /- 0.5 vs. 9.0 + /- 1.1 nmol/L ; P < 0.03 ) , and 3 alpha-diolglucuronide ( 8.6 + /- 1.1 vs. 11.7 + /- 1.9 ; P < 0.005 ) plasma concentrations and a significant increase in the glucose/insulin ratio ( 0.047 + /- 0.005 vs. 0.035 + /- 0.003 ; P < 0.001 ) and plasma concentrations of SHBG ( 26.0 + /- 3.3 vs. 19.1 + /- 1.9 nmol/L ; P < 0.001 ) and dehydroepi and rosterone sulfate ( 8.7 + /- 1.5 vs. 8.4 + /- 1.3 ; P < 0.05 ) . Beneficial effects of diet were not significantly different in the patients who were given metformin instead of placebo . These results confirm that weight loss induced by a low calorie diet is effective in improving hyperinsulinemia and hyper and rogenism in obese and hirsute women . With our study design , metformin administration had no additional benefit over the effect of diet We investigated the role of adrenal and rogens , cortisol , testosterone and sex-hormone binding globulin ( SHBG ) as coronary risk factors using a nested case-control design . The study population consisted of 62 cases with cardiac end-points and 97 controls on placebo during the last 4 years in the Helsinki Heart Study .  Serum concentrations of dehydroepi and rosterone , dehydroepi and rosterone sulfate ( DHEAS ) , and rostenedione , and rostanediol glucuronide , cortisol , testosterone , and SHBG  at the first annual visit of the 5-year study period were determined by radioimmunoassays . The only significant difference was found in DHEAS , with cases having higher levels than controls ( P < 0.04 ) . DHEAS levels were positively associated with smoking ( P < 0.001 ) , alcohol consumption ( P < 0.04 ) and triglyceride levels ( P < 0.002 ) and with systolic ( P < 0.04 ) and diastolic ( P < 0.006 ) blood pressures , and negatively associated with age ( P < 0.01 ) and HDL-cholesterol ( P < 0.03 ) . The association between DHEAS and the CHD risk was studied using logistic regression analyses with the classical risk factors -- age , smoking , blood pressure , and lipid levels -- as covariates in the models . Studies of the joint effects of age and DHEAS disclosed that the risk associated with elevated DHEAS was confirmed to older men ( odds ratio ( OR ) 7.3 , 95 % , CI 2.3 - 23.3 ) . A similar analysis with smoking revealed that the DHEAS-related risk was mainly found in smokers ( OR 3.4 , 95 % CI 1.5 - 8.2 ) . One possible explanation for these results is that some form of mild steroid biosynthetic defect of the adrenals or functional adrenal hyperplasia associated with high DHEAS levels increases the CHD risk in this population Background —Despite diffuse effects of sex hormones on the cardiovascular system , few prospect i ve studies have examined the relationship of plasma and rogens and estrogens with risk of cardiovascular disease ( CVD ) in postmenopausal women . Methods and Results —A nested case-control study was performed among women in the Women ’s Health Study . Two hundred women who developed CVD were matched 1:1 by age , smoking , and postmenopausal hormone therapy ( HT ) to controls who remained free of CVD . We measured testosterone , estradiol , and sex hormone binding globulin ( SHBG ) levels and calculated free and rogen index ( FAI ) , free estradiol index , and the FAI/free estradiol index ratio .  Results were stratified by HT use . Among HT nonusers , cases had significantly higher and rogen profiles ( higher median FAI and lower SHBG levels ) than controls . After adjustment for age , smoking , use of aspirin , vitamin E , and alcohol , family history of myocardial infa rct ion , and physical activity , nonusers in the lowest SHBG quartile had an OR of 2.25 ( 95 % CI , 1.03 to 4.91 ) for CVD , and there were significant trends across FAI quartiles ( P for trend=0.03 ) . Additional adjustment for body mass index , hypertension , diabetes , and elevated cholesterol eliminated associations with SHBG and FAI . Among women using HT , no significant differences in hormones or SHBG were observed among women who developed CVD and controls . Conclusions —Among HT nonusers , lower SHBG and higher FAI levels were noted among postmenopausal women who developed CVD events , but this was not independent of body mass index and other cardiovascular risk factors . Estradiol levels were not associated with risk of CVD in  HT  users or nonusers
However , subgroup analyses for the estrogen dose and the progestin type in relation to changes in SHBG levels did show significant differences : COCs containing second generation progestins and /or the lower estrogen doses ( 20–25 µg EE ) were found to have less impact on SHBG concentrations .
The current literature review and meta- analysis demonstrates that COCs decrease circulating levels of total T and free T and increase SBHG concentrations .
Due to the SHBG increase , free T levels decrease twice as much as total T. The estrogen dose and progestin type of the COC do not influence the decline of total and free T , but both affect SHBG .
BACKGROUND Combined oral contraceptives ( COCs ) reduce levels of and rogen , especially testosterone ( T ) , by inhibiting ovarian and adrenal and rogen synthesis and by increasing levels of sex hormone-binding globulin ( SHBG ) .
Although this suppressive effect has been investigated by numerous studies over many years , to our knowledge no systematic review concerning this issue had been performed .