{
  "abstract": "Background\n\nHormonal contraceptives (HCs) modulate endocrine and metabolic function. Some formulations have been associated with reduced insulin sensitivity, increasing the functional demand on pancreatic β-cells. This systematic review synthesised evidence on pancreatic β-cell adaptation to HC exposure.Methods\n\nIn accordance with PRISMA 2020, PubMed, Scopus and Wiley Online Library were searched for records published from January 2000 to December 2025, combining terms for β-cell function and adaptation with terms for hormonal contraceptives and for glucose homeostasis and insulin resistance. Eligible studies were original investigations in humans and rodents examining β-cell structural, functional or signalling adaptation to HC exposure, with a comparison group or pre-exposure baseline. Risk of bias was assessed by design using RoB 2, NIH and Newcastle-Ottawa criteria, SYRCLE, and adapted in vitro indicators. Findings were synthesised thematically.Results\n\nOf 502 records identified, seven studies met the criteria: four human, two rodent in vivo and one isolated islet study. In women, ethinylestradiol with norgestimate improved insulin sensitivity in lean participants but reduced it in those with obesity; a drospirenone-containing pill raised HOMA-IR; an oral levonorgestrel preparation reduced insulin sensitivity more than an etonogestrel vaginal ring, with β-cell function unaltered by either; and androgenic formulations amplified postprandial glucose and insulin responses despite unchanged fasting values. In rodents, drospirenone-containing exposure produced hyperinsulinemia with preserved glucose tolerance, attributable to enhanced secretory activity and reduced insulin clearance; levonorgestrel impaired glucose tolerance and raised HOMA-IR, HOMA-β and circulating corticosterone. In isolated rat islets, gestodene metabolites increased insulin and glucokinase expression and glucose-stimulated insulin secretion via oestrogen receptor-dependent pathways.Conclusion\n\nEffects of HC on glucose metabolism and β-cell function appear to depend on progestin composition, route of administration and pre-existing metabolic status. Longitudinal human studies using direct measures of secretory capacity are needed to establish whether compensatory capacity is sustained under continued exposure.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medical Physiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Aime Patrick Niyomugabo",
      "orcid": "0009-0003-1327-8722"
    },
    {
      "affs": [
        0
      ],
      "name": "Olufunke Onaadepo"
    },
    {
      "affs": [
        0
      ],
      "name": "Leopold Ntakirutimana",
      "orcid": "0009-0008-6241-4942"
    },
    {
      "affs": [
        0
      ],
      "name": "Muluken Walle Birhanie",
      "orcid": "0000-0002-9800-3597"
    },
    {
      "affs": [
        0
      ],
      "name": "Onyinye Cynthia Okeke",
      "orcid": "0000-0001-6575-4776"
    },
    {
      "affs": [
        0
      ],
      "name": "Abdul-Rahuf Aderemi Feyitimi"
    },
    {
      "affs": [
        0
      ],
      "name": "Ejike Daniel Eze",
      "orcid": "0000-0002-9119-8870"
    },
    {
      "affs": [
        0
      ],
      "name": "Abdulazeez Jimoh"
    },
    {
      "affs": [
        0
      ],
      "name": "Abdullateef Isiaka Alagbonsi",
      "orcid": "0000-0002-5462-9950"
    },
    {
      "affs": [
        0
      ],
      "name": "Makinde Vincent Olubiyi",
      "orcid": "0000-0003-4439-8631"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6mfq2qwj5s3fd.bib",
  "cited_by": 0,
  "doi": "10.2147/oajc.s629161",
  "fulltext_url": "https://europepmc.org/articles/PMC13726598",
  "id": "6mfq2qwj5s3fd",
  "issns": [
    "1179-1527"
  ],
  "landing_url": "https://europepmc.org/article/MED/42974476",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
    [
      "openalex",
      "2746|Pancreatic function and diabetes"
    ]
  ],
  "openalex": "W7224122425",
  "pdf_url": "https://europepmc.org/articles/PMC13726598?pdf=render",
  "pmcid": "PMC13726598",
  "pmid": "42974476",
  "published": "2026-10-29",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/6mfq2qwj5s3fd.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:47Z",
      "native_id": "MED:42974476",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42974476"
    },
    {
      "first_seen": "2026-11-05T12:22:54Z",
      "native_id": "PMC13726598",
      "source": "pmc",
      "url": "https://doi.org/10.2147/oajc.s629161"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Pancreatic function and diabetes",
      "subfield": "surgery"
    }
  ],
  "title": "Impact of Hormonal Contraceptive Exposure on Pancreatic β-Cell Adaptation and Glucose Homeostasis: A Systematic Review.",
  "title_text": "Impact of Hormonal Contraceptive Exposure on Pancreatic β-Cell Adaptation and Glucose Homeostasis: A Systematic Review.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:30Z",
  "url": "https://research.draconitic.com/paper/6mfq2qwj5s3fd",
  "venue": "Open access journal of contraception",
  "versions": []
}