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The injectable contraceptives depot medroxyprogesterone acetate and norethisterone enanthate substantially and differentially decrease testosterone and sex hormone binding globulin levels: A secondary study from the WHICH randomized clinical trial

Author

Listed:
  • Chanel Avenant
  • Mandisa Singata-Madliki
  • Alexis J Bick
  • Donita Africander
  • Yusentha Balakrishna
  • Karl-Heinz Storbeck
  • Johnson M Moliki
  • Sigcinile Dlamini
  • Salndave Skosana
  • Jenni Smit
  • Mags Beksinska
  • Ivana Beesham
  • Ishen Seocharan
  • Joanne Batting
  • George J Hofmeyr
  • Janet P Hapgood

Abstract

HIV acquisition risk with norethisterone (NET) enanthate (NET-EN) is reportedly less than for depo-medroxyprogesterone acetate intramuscular (DMPA-IM). We investigated the effects of these progestin-only injectable contraceptives on serum testosterone and sex hormone binding globulin (SHBG) levels, since these may play a role in sexual behavior and HIV acquisition. The open-label WHICH clinical trial, conducted at two sites in South Africa from 2018–2019, randomized HIV-negative women aged 18–40 years to 150 mg DMPA-IM 12-weekly (n = 262) or 200 mg NET-EN 8-weekly (n = 259). We measured testosterone by UHPLC-MS/MS and SHBG by immunoassay in matched pairs of serum samples collected at baseline (D0) and at peak serum progestin levels at 25 weeks post initiation (25W) (n = 214–218 pairs). Both contraceptives substantially decreased, from D0 to 25W, the total testosterone [DMPA-IM D0 0.560, 25W 0.423 nmol/L, -24.3% (p

Suggested Citation

  • Chanel Avenant & Mandisa Singata-Madliki & Alexis J Bick & Donita Africander & Yusentha Balakrishna & Karl-Heinz Storbeck & Johnson M Moliki & Sigcinile Dlamini & Salndave Skosana & Jenni Smit & Mags , 2024. "The injectable contraceptives depot medroxyprogesterone acetate and norethisterone enanthate substantially and differentially decrease testosterone and sex hormone binding globulin levels: A secondary," PLOS ONE, Public Library of Science, vol. 19(8), pages 1-15, August.
    • Handle: RePEc:plo:pone00:0307736
    DOI: 10.1371/journal.pone.0307736
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    References listed on IDEAS

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    1. Charles S Morrison & Pai-Lien Chen & Cynthia Kwok & Jared M Baeten & Joelle Brown & Angela M Crook & Lut Van Damme & Sinead Delany-Moretlwe & Suzanna C Francis & Barbara A Friedland & Richard J Hayes , 2015. "Hormonal Contraception and the Risk of HIV Acquisition: An Individual Participant Data Meta-analysis," PLOS Medicine, Public Library of Science, vol. 12(1), pages 1-26, January.
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