In the menopausal transition (MT), combined oral contraceptive (COC) should be chosen
accordingly to its neutrality on liver metabolism and to its ability to counter the increase of fat
mass (FM) that occurs in this reproductive period of life. This prospective multi-centric
observational study was conducted on 36 women in their MT at the Universities of Cagliari,
Modena and Naples. The body weight (BW), the Body Mass Index (BMI), the waist to hip ratio
(WHR), the measurement of body composition (BC) with the Multi-frequency Bioelectrical
Impedance (MF-BIA) were performed before, at the 6th and at the 12th month of the study in
which a group of women (control group; N.18) did not assume COC, whereas the other
18 women assumed the four-phasic COC containing estradiol valerate (EV) associated with
dienogest (EV/DNG group). In comparison to controls in the EV/DNG group, a significant
decrease (p50.05) of BW (58.8 ± 7.6 to 57.3 ± 7.0), BMI (24.1 ± 2.7 to 23.5 ± 2.8), WHR
(0.82 ± 0.052 to 0.79 ± 0.048) and FM (17.7 ± 5.4 to 16.4 ± 5.6) was observed. In controls, FM
significantly increased (17.0 ± 11 to 17.7 ± 2.7; p50.05). In conclusion, these results suggest that
the anti-androgenic and progestinic activities of DNG associated with a weak estrogenic activity
of EV, is a contraceptive method capable of counteracting the negative changes of BC
occurring in the MT.
