Can changes in sex hormone binding globulin predict the risk of venous thromboembolism with combined oral contraceptive pills?

Viveca Odlind, Ian Milsom, Ingemar Persson, Arne Victor
Acta obstetricia et gynecologica Scandinavica · 2002 · vol. 81(6) , pp. 482–490 · doi:10.1034/j.1600-0412.2002.810603.x · PMID:12047300 · W2109958433
Review OA: bronze CC0 ⤵ 6 in-corpus citations
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This review proposes that combined oral contraceptive-induced changes in sex hormone binding globulin can predict venous thromboembolism risk, correlating higher SHBG increases with greater VTE risk.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

BACKGROUND: Recent studies have indicated that the risk of thromboembolic disease (VTE) in users of combined oral contraceptive pills (COCs) varies not only with estrogen dose, but also with the progestogen in pills with the same estrogen dose. The aim of this article is to discuss sex hormone binding globulin (SHBG) as a marker of estrogenicity and as a surrogate indicator for the potential risk of VTE in users of COC. MATERIAL AND METHODS: Using data from the literature, we investigated the relationship between the risk of VTE with various COCs and their effects on SHBG. We also collected data on the effects on SHBG by some combined preparations, where there are no VTE data. RESULTS: There appears to be a relationship between the risk of VTE and the effect on SHBG. Monophasic preparations containing levonorgestrel, having the lowest risk of VTE, cause an average SHBG increase of around 50%. COCs containing desogestrel or gestodene cause an average SHBG increase of 200-300%. A preparation with cyproterone acetate, carrying a higher risk of VTE than desogestrel and gestodene, cause a 300-400% SHBG increase. With the recently developed combined preparations, there is a 150% SHBG increase with norgestimate and a 250-300% increase with drosperinone and dienogest. CONCLUSIONS: We propose that the change in SHBG with a COC could be interpreted as a measure of total estrogenicity and used as a predictor of the risk of VTE. Preparations containing drosperinone, dienogest, cyproterone acetate and norgestimate are equally or more estrogenic than the more thoroughly studied COCs, containing desogestrel or gestodene and should not be considered a safer substitute.

My notes (saved in your browser only)

MeSH descriptors

Biomarkers Contraceptives, Oral, Combined Norgestrel Sex Hormone-Binding Globulin Venous Thrombosis Biomarkers Contraceptives, Oral, Combined Cyproterone Acetate Desogestrel Female Humans Levonorgestrel Norgestrel Norpregnenes Predictive Value of Tests Risk Factors Sex Hormone-Binding Globulin Venous Thrombosis

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (56)

Cited by (6)

Source provenance

openalex
last seen: 2026-05-11T03:50:07.206254+00:00
pubmed
last seen: 2026-10-08T21:00:31.392641+00:00
License: CC0 · commercial use OK