The Effect Of Combined Oral Contraceptive Pills (Cocp) Containing Levonorgestrel And Ethinylestradiol On Kidney Function

Download Article

Authors : Ekhator C.N, Omorogiuwa A., Akpamu U



Despite the modifications on Oral Contraceptive Pills (OCPs) in term of content and dosage to lessen their side effect, paucity of information existed on the effect of COCP on kidney function.


Hence, this study investigates the effect of COCP containing 0.15mg levonorgestrel (a progestogen) and 0.03mg ethinylestradiol (an estrogen) on kidney biochemical parameters and electrolytes.


The study involves 15 female rabbits divided into three groups (A, B and C). Group A served as the control, while B and C served as the test groups and were administered the COCP per body weight human doses for 7 days and 14 days respectively. At the end of the study, blood sample was obtained for the determination of plasma creatinine, urea, Na, Cl and K using standard laboratory procedures.


Results showed significant increase (p<0.05) in plasma creatinine, urea and K+ but a decreases in plasma Na+ and Cl-in the tests compared to the control.


Considering the observed changes in the parameters herein studied, COCPs usage is not without impact on kidney function and may cause homeostasis dysfunction and hence the need for further studies. 


[1.] American College of Obstetricians and Gynecologists. (1992). Safety of oral contraceptives for teenagers. J. Adolesc. Health; 13:333–336.

[2.] Avonts D, Sercu M, Heyrich P, Vandermeeren I, Meheus A and Pilot P (1990) Incidence of uncomplicated genital infections in women using oral contraceptives or an uterine device: A prospective study. Sexually transmited dis.; 17 (1), 23-29.

[3.] Bagshaw S. (1995). The combined oral contraceptive: risks and adverse effects in perspective. Drug Saf.; 12 (2): 91-6.

[4.] Baillargeon, J., McClish, D.K., Essah, P.A. and Nestler, J.E. (2005). Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis.

[5.] J. Clin. Endocrinol. Metab.; 90: 3863–3870.

[6.] Baker FJ, Silverton RE, Pallister CJ (1998). Baker and Silverton‘s Introduction to Medical

[7.] Laboratory Technology, seventh ed.

[8.] Briggs M (1978) Biochemical basis for the selection of oral contraceptives. Int. J. Gynecol. Obstet. 39 (8), 19.

[9.] Burkman, R.T., Collins, J.A., Shulman, L.P. and Williams, J.K. (2001). Current perspectives on oral contraceptive use. Am. J. Obstet. Gynecol.; 185 (Suppl. 2): S4–S12.

[10.]   Ekhator C.N. and Osifo U.C. (2012). The effect of oral contraceptive pills (OCP) on body weight: a call for further studies. IJBAIR 1 (4): 155 – 160.

[11.]   Endrikat J, Jaques MA, Mayerhofer M, Pelissier C, Mu¨ ller U, Du¨ sterberg B 1995 A twelve-month comparative clinical investigation of two low-dose oral contraceptives containing 20g ethinylestradiol/75ug gestodene and 20ug ethinylestradiol/150ug desogestrel, with respect to efficacy, cycle control and tolerance. Contraception; 52:229–235.

[12.]   Fotherby K, Caldwel ADS. New Progestogens in oral contraception. Contraception 1994 Jan; 49:1-32.

[13.]   Grinspoon SK, Friedman AJ, Miller KK, Lippman J, Olson WH and Warren MP (2003) Effects of a triphasic combination oral contraceptive containing Norgestimate/ethinyl estradiol on biochemical markers of bone metabolism in young women with osteopenia secondary to hypothalamic amenorrhea. J. Clin. Endocrinol. Metabolism. 88 (8), 3651-3656.

[14.]   Henderson M, Dorflinger J, Fishman J, Foster HW and Gump FE, Hellman S, Hulka BS, Mattison DR, McKay SAR, Moses LE, Norsigian J, Potts M, Schwartz NB, Smith H, Stolley PD and Wiggins PV (1991) Oral contraceptives and breast cancer. National Academy Press. 1-77.

[15.]   Kemmeren, J.M., Algra, A. and Grobbee, D.E. (2001). Third generation oral contraceptives and risk of venous thrombosis: meta analysis. Br. Med. J.; 323: 131–134.

[16.]   Klipping C, Marr J. (2005). Effects of two combined oral contraceptives containing ethinyl estradiol 20 microg combined with either drospirenone or desogestrel on lipids, hemostatic parameters and carbohydrate metabolism. Contraception; 71: 409-16.

[17.]   Myles K, Funder JW. (1996). Progesterone binding to mineralocorticoid receptors: in vitro and in vivo studies. Am J Physiol Endocrinol Metab 270: E601–E607.

[18.]   Oelkers W, Foidart JM, Dombrovicz N, Welter A, Heithecker R. (1995). Effects of a new oral contraceptive containing an antimineralocorticoid progestogen, drospirenone, on the renin­aldosterone system, body weight, blood pressure, glucose tolerance, and lipid metabolism. J Clin Endocrinol Metab; 80: 1816-21.

[19.]   Oelkers WK. (1996). Effects of estrogens and progestogens on the renin-aldosterone system and blood pressure. Steroids 61: 166–171.

[20.]   Oian P, Tollan A, Fadnes HO, Noddeland H, Maltau JM. (1987). Transcapillary fluid dynamics during the menstrual cycle. Am J Obstet Gynecol 156: 952–955.

[21.]   Okoye NF, Uwakwe AA and Ayalogu EO (2012). Effects of oral contraceptives -Microgynon and Primolut-N on plasma creatinine of wistar albino rat. Indian Journal of Medicine and Healthcare. 1 (7): 168 – 171.

[22.]   Sims TS., Rehrer, JN., Bell, LM. and Cotter, DJ. (2008). Endogenous and exogenous female sex hormones and renal electrolyte handling: effects of an acute sodium load on plasma volume at rest. J Appl Physiol 105: 121–127.

[23.]   Smith RP and Sizto R (1983) Metabolic effects of two triphasic formulations containing ethinyl estradiol and dl-norge¬strel. J. Contraception. 28 (2), 189-199.

[24.]   Spruce BA, Baylis PH, Burd J, Watson MJ. (1985). Variation in osmoregulation of arginine vasopressin during the human menstrual cycle. Clin Endocrinol (Oxf) 22: 37–42.

[25.]   Stachenfeld NS, Keefe DL, Palter SF. (2001). Estrogen and progesterone effects on transcapillary fluid dynamics. Am J Physiol Regul Integr Comp Physiol 281: R1319–R1329.

[26.]   Surasak, Taneepanichskul, Unnop, Jaisamrarn, Vorapong, Phupong. (2007). Effect of a New Oral Contraceptive with Drospirenone on Vital Signs, Complete Blood Count, Glucose, Electrolytes, Renal, and Liver Function. J Med Assoc Thai; 90 (3): 426-31

[27.]   Trussell, J. (2007). Contraceptive Efficacy. In Hatcher, Robert A., et al.. Contraceptive Technology (19th rev. ed.). Ardent Media. New York.

[28.]   Tsalev, D.L. and Zaprianov, Z.K. (1984). Atomic absorption spectrometry in occupational and environmental health practice. CRC Press Inc. Boca Raton, FL.

[29.]   Vokes, T,J,, Weiss, N,M,, Schreiber, J., Gaskill, M.B., Robertson G.L. (1988). Osmoregulation of thirst and vasopressin during normal menstrual cycle. Am J Physiol Regul Integr Comp Physiol 254: R641–R647.