CBG Normalization After Discontinuation of COC's
The Effect of Discontinuing Estrogen Containing Oral Contraceptives on Corticosteroid-binding Globulin and Total Cortisol Concentrations
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Use of exogenous estrogens is known to increase corticosteroid-binding globulin (CBG) levels and thereby total cortisol concentrations measured in serum. When endocrine function are performed to assess hypothalamus-pituitary-adrenal function, total cortisol levels are measured in serum. When women use exogenous oral estrogen, for instance the birth control pill, the current recommendation is to discontinue oral estrogens for at least 6 weeks before the test. This may introduce diagnostic delay and inconvenience for the patient. The duration it takes for CBG concentrations to return to normal, have not been studied in vivo as far as known by the investigators.
The main objective of this prospective observational study is to determine the duration in which CBG and total cortisol concentrations return to normal after cessation of oral estrogen. Secondary objectives are to examine the normalization of other hormone binding proteins and their corresponding hormones (VDBP & vitamin D; TBG & T4, T3; SHBG & testosterone; IGFBP3 & IGF1).
The study population consists of healthy women aged ≥18 years old, who are planning to stop using combined oral contraceptives (COCs) for at least six weeks. The study consists of 8 weekly blood samples. The first blood sample will be performed one week before cessation of COCs, the second one at the moment of cessation and after cessation the next six weekly blood samples will be taken.
After establishing when values return to normal, doctors have a better idea of how many weeks after stopping COCs, blood results can be properly assessed. If the duration were shorter than six weeks, this would mean less inconvenience for women undergoing dynamic function tests who would have to stop taking their contraceptive pill.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Annemieke C Heijboer, Prof. Dr.
- Phone Number: +31 020 566 5940
- Email: a.heijboer@amsterdamumc.nl
Study Contact Backup
- Name: Karlijn Koops, Drs.
- Email: k.koops@amsterdamumc.nl
Study Locations
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Amsterdam, Netherlands, 1105 AZ
- Amsterdam UMC
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- ≥18 years old
- Using oral combined contraceptives of any kind and dosage
- Planning to stop COC use shortly for at least 6 weeks (out of own reasons such as a pregnancy wish or choice for non-hormone based contraceptives)
- COC use for at least 3 consecutive weeks before the discontinuation
- Ability to provide informed consent
- Ability to speak and understand Dutch
Exclusion Criteria:
- Switching to other hormonal contraceptives after taking the COC pill (e.g. progesterone containing contraceptives such as the Mirena IUD, contraceptive implants) directly after the discontinuations
- Contra-indications to quit COC
Biological factors that affect CBG concentrations, including:
- Illnesses interfering with CBG levels (severe liver or kidney disease, active malignancy, hyperthyroidism)
- Use of insulin, systemic exogenous glucocorticoids, mitotane, selective estrogen receptor modulators (SERMs)
- Pregnancy during study period after discontinuation of COCs
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Time to normalization of CBG and total cortisol concentrations
Time Frame: 8 weeks
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Time in weeks until plateau is reached.
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8 weeks
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Time to normalization of VDBP, vitamin D, TBG, T4, T3, SHBG, testosterone, IGFBP3 and IGF1
Time Frame: 8 weeks
|
Time in weeks until plateau is reached.
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8 weeks
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Estradiol concentration
Time Frame: 8 weeks
|
Used for determining menstrual cycle
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8 weeks
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Progesterone concentration
Time Frame: 8 weeks
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Used for determining menstrual cycle
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8 weeks
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LH concentration
Time Frame: 8 weeks
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Used for determining menstrual cycle
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8 weeks
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FSH concentration
Time Frame: 8 weeks
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Used for determining menstrual cycle
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8 weeks
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Occurrence of vaginal blood loss
Time Frame: 8 weeks
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Used for determining menstrual cycle
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8 weeks
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Albumin concentration
Time Frame: 8 weeks
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8 weeks
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|
|
Prolactin concentration
Time Frame: 8 weeks
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8 weeks
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fT3 and fT4 concentration
Time Frame: 8 weeks
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8 weeks
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TSH concentration
Time Frame: 8 weeks
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8 weeks
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HCG concentration
Time Frame: Measured at 6th week after cessation of COCs
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Measured at 6th week after cessation of COCs
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Annemieke C Heijboer, Prof. Dr., Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Laboratory Medicine, Endocrine Laboratory, Boelelaan 1117, Amsterdam, The Netherlands
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- NL87932.018.24
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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