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The effects of contraceptives on the anti-oxidant status, skin parameters and anthropometric indicators in female students: a pilot study
Germishuys, Martha Petronella
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Introduction: The provision of access to safe and effective contraception is a critical element in the health of women that enables them to make choices about their fertility. This element of control empowers them and indirectly enables them to access better social and economic opportunities. Hormonal contraceptives are a convenient, effective and relatively safe method of fertility control. Extensive research has been done on the effects of hormonal contraceptives on undesirable metabolic and haemostatic changes, but data on the relationship between oxidative stress and oral contraceptives is scarce and remains subject to debate. Aging of the skin due to oestrogen loss at menopause is thought to include atrophy, decreased collagen content, water content, and sebaceous secretions, loss of elasticity, wrinkling, poor wound healing and manifestations of hyperandrogenism. A number of studies have shown that oestrogens serve many important beneficial and protective functions in skin physiology. Despite extensive clinical experience, many metabolic effects of oral contraceptive treatment remain to be explored. The effects of progesterone on body weight and composition are of interest from several standpoints. Since hormonal contraceptives are widely used, it is important to investigate the effect thereof on oxidative status, skin parameters and anthropometric indicators, to enable women make informed choices about the use of contraceptives, or to adapt their lifestyle if necessary. The aim of the present study was therefore, to assess certain effects of contraceptives in a student population at the Cape Peninsula University of Technology (CPUT). Objectives of the study: To determine the differences in skin health, anthropometric \parameters and oxidative stress status in female university students using various hormonal contraceptives versus non-contraceptive users. Research design: The study adopted a quantitative approach to examine a crosssectional research sample in order to provide a snapshot of the population at a particular time. Concenting participants were selected through the use of questionnaires aimed at ascertaining the type of contraceptive used as well as general health and lifestyle patterns. Blood samples were collected and the antioxidant status was determined. Body composition and skin analysis was conducted on each of the participants in the selected groups and the results were compared to determine the differences between contraceptive and non-contraceptive users. Results: With regards to oxidative stress status, the results indicated a significant increase in superoxide dismutase (SOD) activities within the triphasic contraceptive group compared to the monophasic contraceptive group, suggesting higher levels of oxidative stress in monophasic contraceptive groups. There was also an increase in lipid peroxidation (TBARS) for the triphasic contraceptive group when compared to the control, monophasic contraceptive and injectable contraceptive groups respectively, indicative of increased oxidative stress levels in the triphasic contraceptive group. In this study, skin parameters evaluation revealed that there was a general increase in the presence of erythema in the monophasic contraceptive group compared to the control; injectable contraceptive; implant contraceptive and triphasic contraceptive groups, symptomatic of higher vascular activity in the monophasic group. Melanocyte activity measured in the forehead, cheek and chin areas were also significantly increased when the monophasic contraceptive group was compared to the control and other contraceptive groups, characterised by the pigmentation pattern of chloasma/melasma known to be caused by hormones. The hydration measurements were significantly increased in the implant contraceptive group compared to the control and monophasic contraceptive groups. Furthermore, a significant increase in hydration was evident in the injectable contraceptive group when compared to the control and monophasic contraceptive groups. Injectable contraceptives and implant contraceptives mainly contain progesterone which has been proven to combat signs of aging and increase collagen and elastin in the skin. With respect to anthropometric measurements, there was a significant increase in the measurement of waist to hip ratio in the implant contraceptive group compared to the control group (non-contraceptive). Progesterone influence on adipose tissue distribution indicated a more significant increase of adipose tissue in the abdominal region. Conclusion: In this study there was some evidence that the type of hormonal contraceptive used does have significant effects on the variables tested in the population sample. These effects are dependent on the composition of the contraceptive and the levels of progesterone and/or oestrogen.