Associations of Combined Oral Contraceptive Use with Inflammatory, Oxidative Stress, and Metabolic Alterations

Background: Combined oral contraceptives (COCs) are the most common method of contraception as well as a management tool for various gynecological conditions. The impact of COCs on oxidative stress and inflammatory status is still to be clarified. Aim: To evaluate the biochemical indicators of oxidative stress and inflammation in COC users. Methods: A total of 93 women (43 COC users and 50 non-users) were enrolled in this comparative observational study. Serum concentrations of malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant capacity (TAC), high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were determined. Metabolic parameters and lipid profile were also examined. Results: Levels of hsCRP and TNF-α in COC users were significantly higher as compared to non-users (p<0.001), whereas the IL-6 levels were comparable between two groups. There was a significant increase in MDA levels and a decrease in SOD activity in COC users (p<0.05). However, TAC was not significantly different. Moreover, COC users had significantly higher glucose level and a worse lipid profile, with higher atherogenic indices (p<0.01). The duration of COC use was positively associated with inflammatory and oxidative stress markers and negatively with antioxidant parameters. Conclusion: Increased oxidative stress, low-grade inflammation, and unfavorable metabolic alterations may be linked to COC use, and such associations could probably be intensified with longer duration of use; therefore, it is advised to monitor women who are using COC for long period; specially those at higher risk of cardiometabolic disease.