Former long‐term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population‐based cohort study

Abstract Introduction Current use of combined hormonal contraceptives worsens glucose tolerance and increases the risk of type 2 diabetes mellitus at late fertile age, but the impact of their former use on the risk of glucose metabolism disorders is still controversial. Material and methods This was...

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Main Authors: Maria‐Elina Mosorin, Meri‐Maija Ollila, Tanja Nordström, Jari Jokelainen, Terhi Piltonen, Juha Auvinen, Laure Morin‐Papunen, Juha Tapanainen
Format: Article
Language:English
Published: Wiley 2023-11-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14636
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author Maria‐Elina Mosorin
Meri‐Maija Ollila
Tanja Nordström
Jari Jokelainen
Terhi Piltonen
Juha Auvinen
Laure Morin‐Papunen
Juha Tapanainen
author_facet Maria‐Elina Mosorin
Meri‐Maija Ollila
Tanja Nordström
Jari Jokelainen
Terhi Piltonen
Juha Auvinen
Laure Morin‐Papunen
Juha Tapanainen
author_sort Maria‐Elina Mosorin
collection DOAJ
description Abstract Introduction Current use of combined hormonal contraceptives worsens glucose tolerance and increases the risk of type 2 diabetes mellitus at late fertile age, but the impact of their former use on the risk of glucose metabolism disorders is still controversial. Material and methods This was a prospective, longitudinal birth cohort study with long‐term follow‐up consisting of 5889 women. The cohort population has been followed at birth, and at ages of 1, 14, 31 and 46. In total, 3280 (55.7%) women were clinically examined and 2780 also underwent a 2‐h oral glucose tolerance test at age 46. Glucose metabolism indices were analyzed in former combined hormonal contraceptive users (n = 1371) and former progestin‐only contraceptive users (n = 52) and in women with no history of hormonal contraceptive use (n = 253). Results Compared with women with no history of hormonal contraceptive use, those who formerly used combined hormonal contraceptives for over 10 years had an increased risk of prediabetes (odds ratio [OR] 3.9, 95% confidence interval [CI]: 1.6–9.2) but not of type 2 diabetes mellitus. Former progestin‐only contraceptive use was not associated with any glucose metabolism disorders. The results persisted after adjusting for socioeconomic status, smoking, alcohol consumption, parity, body mass index and use of cholesterol‐lowering medication. Conclusions Former long‐term use of combined hormonal contraceptives was associated with a significantly increased risk of prediabetes in perimenopausal women, which potentially indicates a need of screening for glucose metabolism disorders in these women.
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spelling doaj-art-4e02fe950fe043f19ff222bec6ff7e962025-08-20T02:36:28ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-11-01102111488149510.1111/aogs.14636Former long‐term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population‐based cohort studyMaria‐Elina Mosorin0Meri‐Maija Ollila1Tanja Nordström2Jari Jokelainen3Terhi Piltonen4Juha Auvinen5Laure Morin‐Papunen6Juha Tapanainen7Department of Obstetrics and Gynecology Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu Oulu FinlandDepartment of Obstetrics and Gynecology Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu Oulu FinlandMedical Research Center Oulu University Hospital, University of Oulu, Wellbeing Services County of North Ostrobothnia Oulu FinlandMedical Research Center Oulu University Hospital, University of Oulu, Wellbeing Services County of North Ostrobothnia Oulu FinlandDepartment of Obstetrics and Gynecology Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu Oulu FinlandCenter for Life Course Health Research University of Oulu, Wellbeing Services County of North Ostrobothnia Oulu FinlandDepartment of Obstetrics and Gynecology Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu Oulu FinlandDepartment of Obstetrics and Gynecology Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of Oulu Oulu FinlandAbstract Introduction Current use of combined hormonal contraceptives worsens glucose tolerance and increases the risk of type 2 diabetes mellitus at late fertile age, but the impact of their former use on the risk of glucose metabolism disorders is still controversial. Material and methods This was a prospective, longitudinal birth cohort study with long‐term follow‐up consisting of 5889 women. The cohort population has been followed at birth, and at ages of 1, 14, 31 and 46. In total, 3280 (55.7%) women were clinically examined and 2780 also underwent a 2‐h oral glucose tolerance test at age 46. Glucose metabolism indices were analyzed in former combined hormonal contraceptive users (n = 1371) and former progestin‐only contraceptive users (n = 52) and in women with no history of hormonal contraceptive use (n = 253). Results Compared with women with no history of hormonal contraceptive use, those who formerly used combined hormonal contraceptives for over 10 years had an increased risk of prediabetes (odds ratio [OR] 3.9, 95% confidence interval [CI]: 1.6–9.2) but not of type 2 diabetes mellitus. Former progestin‐only contraceptive use was not associated with any glucose metabolism disorders. The results persisted after adjusting for socioeconomic status, smoking, alcohol consumption, parity, body mass index and use of cholesterol‐lowering medication. Conclusions Former long‐term use of combined hormonal contraceptives was associated with a significantly increased risk of prediabetes in perimenopausal women, which potentially indicates a need of screening for glucose metabolism disorders in these women.https://doi.org/10.1111/aogs.14636combined hormonal contraceptionglucose metabolism disordersOGTTprediabetesprogestin‐only contraceptiontype 2 diabetes mellitus
spellingShingle Maria‐Elina Mosorin
Meri‐Maija Ollila
Tanja Nordström
Jari Jokelainen
Terhi Piltonen
Juha Auvinen
Laure Morin‐Papunen
Juha Tapanainen
Former long‐term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population‐based cohort study
Acta Obstetricia et Gynecologica Scandinavica
combined hormonal contraception
glucose metabolism disorders
OGTT
prediabetes
progestin‐only contraception
type 2 diabetes mellitus
title Former long‐term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population‐based cohort study
title_full Former long‐term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population‐based cohort study
title_fullStr Former long‐term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population‐based cohort study
title_full_unstemmed Former long‐term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population‐based cohort study
title_short Former long‐term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population‐based cohort study
title_sort former long term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women a prospective population based cohort study
topic combined hormonal contraception
glucose metabolism disorders
OGTT
prediabetes
progestin‐only contraception
type 2 diabetes mellitus
url https://doi.org/10.1111/aogs.14636
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