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

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 and Janet P Hapgood

PLOS ONE, 2024, vol. 19, issue 8, 1-15

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

Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0307736

DOI: 10.1371/journal.pone.0307736

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