Dissociation of gonadal and adrenal androgens one year after etonogestrel implant insertion
European Journal of Contraception and Reproductive Health Care, cilt.31, sa.5, ss.362-370, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 31 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1080/13625187.2026.2692388
- Dergi Adı: European Journal of Contraception and Reproductive Health Care
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Psycinfo, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Sayfa Sayıları: ss.362-370
- Anahtar Kelimeler: Etonogestrel implant, long-acting reversible contraception, androgens, sex hormone-binding globulin, free testosterone, menstrual bleeding pattern
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Paired hormonal data spanning a full androgen panel before and during etonogestrel (ENG) implant use are scarce. We quantified within-subject hormonal change about one year after ENG implant insertion and tested whether it differed by menstrual bleeding phenotype. Methods: In this paired cohort study, 200 women with an ENG 68 mg implant in situ for 10–14 months attended a single index visit. Pre-insertion hormone values, obtained routinely before insertion, were retrieved from records; current values were measured at the index visit in the same laboratory. Paired comparisons used the Wilcoxon signed-rank test, reporting Cohen’s dz and absolute change with 95% CIs; post-implant values were compared between bleeding phenotypes by ANCOVA adjusted for age, BMI, and parity, with multiple-testing correction. Results: LH showed the largest decrease (−47.1%; dz = 1.84), followed by SHBG (−49.8%; dz = 1.42), total testosterone (−45.3%; dz = 1.24), and free testosterone (−46.0%; dz = 1.08). Oestradiol, AMH, and DHEA-S changed by ≤3% and, though significant, were clinically negligible (dz ≤ 0.60). Regular monthly bleeding fell from 95.5% to 45.0% (p < 0.001), with no frequent, prolonged, or heavy bleeding. After adjustment, no hormonal value differed by bleeding phenotype (all p ≥ 0.38). Conclusion: One year after ENG implant insertion, deep LH suppression was accompanied by parallel reduction of gonadal androgens (total and free testosterone) and SHBG, whereas oestradiol, AMH, and adrenal DHEA-S were essentially unchanged, indicating a dissociation between suppressed gonadal and preserved adrenal androgens. The reduced-bleeding phenotype was not accompanied by differential hormonal change.