eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 15
Letter to the Editor

Vitamin D serum levels in women using contraception containing drospirenone – a preliminary study

Michał Ciebiera, Marta Włodarczyk, Aneta Słabuszewska-Jóźwiak, Magdalena Ciebiera, Grażyna Nowicka, Grzegorz Jakiel

Arch Med Sci 2019; 15, 2: 554–557
Online publish date: 2017/10/20
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Vitamin D is a group of steroid compounds soluble in fats. Vitamin D has powerful, pleiotropic effects all over the human body. It is synthesized in human skin, but can also be found in dietary supplements and fortified foods. Vitamin D receptors (VDR) can be found in many tissues, as well as in the female reproductive tract [1, 2]. According to recent reports, it is believed that vitamin D has a beneficial effect on lowering the risk of various diseases, e.g. multiple forms of cancer, diabetes, cardiovascular diseases, metabolic syndrome, multiple sclerosis, inflammatory bowel diseases and uterine fibroids [1–6]. Vitamin D regulates cell proliferation and differentiation, inhibits angiogenesis and stimulates apoptosis [1, 2, 4, 5]. Vitamin D levels are mostly measured using serum 25-hydroxyvitamin D (25(OH)D) concentration, which is considered to be the best known marker of vitamin D obtained through both diet and body synthesis. According to Holick, the vitamin D level should be higher than 30 ng/ml [1].
Ethinylestradiol (EE2) is a derivative of 17-estradiol (E2), the major endogenous human estrogen. EE2 is used in many forms of combined oral contraception (COC) and is one of the most commonly used medications for this purpose. Ethinylestradiol is hormonally effective by activating the estrogen receptor and thus exerts its estrogenic effects [7].
Drospirenone is a steroidal progestin (of the spironolactone group) used in contraception and hormonal replacement therapy. It is also an aldosterone antagonist with potassium-sparing properties. It is an agonist of the progesterone receptor and an antagonist of the mineralocorticoid and androgen receptors, and hence a progestagen, antimineralocorticoid and antiandrogen. Drospirenone does not present any estrogenic or glucocorticoid or antiglucocorticoid activity. It has a potent antigonadotropic effect at sufficient dosages as a result of progesterone receptor activation. It has been stated that drospirenone has a pharmacological profile that is closely related to that of natural progesterone [8]. Drospirenone is about ten times more potent as an antimineralocorticoid in comparison to spironolactone [8–10]. The drospirenone antimineralocorticoid activity promotes sodium excretion and prevents water retention [10].
It is believed that contraceptives containing estrogens or estrogens combined with progestins may affect 25(OH)D serum concentrations. There is a lack of reports in this...

View full text...
Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-81.
Holick MF. Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr 2004; 79: 362-71.
Pelczyńska M, Grzelak T, Sperling M, Bogdański P, Pupek-Musialik D, Czyżewska K. Impact of 25-hydroxyvitamin D, free and bioavailable fractions of vitamin D, and vitamin D binding protein levels on metabolic syndrome components. Arch Med Sci 2017; 13: 745-52.
Brannon PM, Yetley EA, Bailey RL, Picciano MF. Overview of the conference “Vitamin D and Health in the 21st century: an update”. Am J Clin Nutr 2008; 88: 483S-90S.
Pludowski P, Holick MF, Pilz S, et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality – a review of recent evidence. Auto­immun Rev 2013; 12: 976-89.
Krela-Kaźmierczak I, Szymczak A, Łykowska-Szuber L, et al. The importance of vitamin D in the pathology of bone metabolism in inflammatory bowel diseases. Arch Med Sci 2015; 11: 1028-32.
Evans G, Sutton EL. Oral contraception. Med Clin North Am 2015; 99: 479-503.
Muhn P, Fuhrmann U, Fritzemeier KH, Krattenmacher R, Schillinger E. Drospirenone: a novel progestogen with antimineralocorticoid and antiandrogenic activity. Ann N Y Acad Sci 1995; 761: 311-35.
Fuhrmann U, Krattenmacher R, Slater EP, Fritzemeier KH. The novel progestin drospirenone and its natural counterpart progesterone: biochemical profile and antiandrogenic potential. Contraception 1996; 54: 243-51.
Genazzani AR, Mannella P, Simoncini T. Drospirenone and its antialdosterone properties. Climacteric 2007; 10 (Suppl. 1): 11-8.
Sowers M, Wallace R, Hollis B, Lemke JH. Parameters related to 25-OH-D levels in a population-based study of women. Am J Clin Nutr 1986; 43: 621-8.
Harris SS, Dawson-Hughes B. The association of oral contraceptive use with plasma 25-hydroxyvitamin D levels. J Am Coll Nutr 1998; 17: 282-4.
Brinker KA. Oral contraceptive use and vitamin D status among women ages 15-44 in the US: a cross-sectional study. 2012. http://pid.emory.edu/ark:/25593/brdcm (online 24.09.2016).
Adami S, Bertoldo F, Braga V, et al. 25-hydroxyvitamin D levels in healthy premenopausal women: association with bone turnover markers and bone mineral density. Bone 2009; 45: 423-6.
Namli Kalem M, Hizli D, Kamalak Z, et al. Effect of combined oral contraceptive use on serum 25-hydroxyvitamin D levels and ultrasound parameters in patients with polycystic ovary syndrome. Gynecol Endocrinol 2016; 32: 281-4.
Viragh E, Horvath D, Locsei Z, et al. Vitamin D supply among healthy blood donors in Vas County, Hungary. Orv Hetil 2012; 154: 1629-37.
Schreurs WH, van Rijn HJ, van den Berg H. Serum 25-hydroxycholecalciferol levels in women using oral contraceptives. Contraception 1981; 23: 399-406.
Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest 2002; 110: 229-38.
Vaidya A, Forman JP, Hopkins PN, Seely EW, Williams JS. 25-Hydroxyvitamin D is associated with plasma renin activity and the pressor response to dietary sodium intake in Caucasians. J Renin Angiotensin Aldosterone Syst 2011; 12: 311-9.
Brown J, Vaidya A. Interactions between adrenal and calcium-regulatory hormones in human health. Curr Opin Endocrinol Diabetes Obes 2014; 21: 193-201.
Nakai K, Kawato T, Morita T, et al. Angiotensin II suppresses osteoblastic differentiation and mineralized nodule formation via AT1 receptor in ROS17/2.8 cells. Arch Med Sci 2015; 11: 628-37.
Alesutan I, Feger M, Pakladok T, et al. 25-Hydroxyvitamin D3 1-alpha hydroxylase-dependent stimulation of renal Klotho expression by spironolactone. Kidney Blood Press Res 2013; 37: 475-87.
Archer DF, Ahrendt HJ, Drouin D. Drospirenone – only oral contraceptive: results from a multicenter noncomparative trial of efficacy, safety and tolerability. Contraception 2015; 92: 439-44.
Brakta S, Diamond JS, Al-Hendy A, Diamond MP, Halder SK. The role of Vitamin D in uterine fibroid biology. Fertil Steril 2015; 104: 698-706.
Ciebiera M, Włodarczyk M, Słabuszewska-Jóźwiak A, Nowicka G, Jakiel G. Influence of vitamin D and transforming growth factor beta3 serum concentrations, obesity, and family history on the risk for uterine fibroids. Fertil Steril 2016; 106: 1787-92.
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe