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PubMed1977

Bromocriptine for induction of ovulation in normoprolactinaemic post-pill anovulation.

19 women with anovulation after discontinuing oral contraceptive agents and with normal plasma-prolactin concentrations were treated with bromocriptine. Ovulation and menstruation were restored in 9 of the 13 amenorrhoeic and 5 of the 6 oligomenorrhoeic patients. The success-rate (74%) indicates that bromocriptine is an effective treatment for post-pill anovulation in normoprolactinaemic women.

Adolescent↗
PubMed1977

Etiology, clinical features and prognosis in secondary amenorrhea.

A clinical investigation of 356 patients with secondary amenorrhea revealed that 95% of patients with postpill amenorrhea and 56% of patients with anorexia nervosa recovered in 6 years. The corresponding recovery rates for patients with psychogenic amenorrhea and amenorrhea following self-induced weight loss were 72% for both groups, and in patients with the amenorrhea-galactorrhea syndrome and idiophatic functional amenorrhea the recovery rates at 6 years were 64 and 61% respectively. Unlike the other groups with functional amenorrhea, patients with the amenorrhea-galactorrhea syndrome had impaired ovarian responsiveness to exogenous gonadotropins. Bromocriptine treatment resulted in disappearance of the galactorrhea and restoration of the menses and/or ovulation in nine of 18 patients; of these three became pregnant. The effect of bromocriptine did not persist for long after treatment ceased, and permanent recovery was recorded only in four patients. The group with functional amenorrhea included 34 patients who wished to become pregnant. Gonadotropin treatment was successful in 20 patients, clomiphene-hCG in two, tamoxifen in two, bromocriptine in two, and combined bromocriptine and clomiphene in one. Thus, the overall pregnancy rate in patients with functional amenorrhea was 79%. The groups with ovarian amenorrhea inclutients with assumed ovarian failure responded to large doses of exogenous gonadotropins by ovulation and three became pregnant. Ovarian wedge resection was ineffective in all five cases with polycystic ovaries, but two patients became pregnant after treatment with clomiphene and chorionic gonadotropin, and one with exogenous gonadotropins.

Amenorrhea↗
PubMed1978

The effect of oral contraceptive treatment on the serum concentration of dehydroisoandrosterone sulfate.

Dehydroisoandrosterone sulfate (DS), the major C19-steroid in the human circulation, was measured in serum obtained from blood samples collected daily (8 to 10 A.M.) throughout the menstrual cycles of eight normal, presumably ovulatory women and daily throughout the treatment cycles in four women taking an oral contraceptive (norethindrone, 1 mg., plus mestranol, 80 mcg.). The serum concentrations of DS in the ovulatory women ranged from 1,025 to 4,200 ng. per milliliter; mean, 2,062 +/- 137 ng. per milliliter (mean and standard error; n = 213). Serum DS concentrations during the follicular and luteal phases of the menstrual cycles of these women were similar. In women taking the oral contraceptive, the plasma DS concentrations ranged from 475 to 1,400 ng. per milliliter (mean, 895 +/- 83; n = 119). The 24 hour secretory pattern of DS was evaluated in one subject during a nontreatment cycle and again after 20 days of oral contraceptive treatment. In this subject, the mean serum DS level was 34 per cent lower during oral contraceptive treatment than the level before treatment. The decrease in the serum concentration of DS during oral contraceptive treatment likely results from a reduction in adrenal DS secretion since DS secretion by the normal human ovary is negligible and ovarian dehydroisoandrosterone secretion is small. Therefore, it is likely that the reduced serum DS levels in women taking oral contraceptives are the consequence of reduced adrenal secretion of DS resulting from reduced release of adrenocorticotropic hormone.

Adrenal Cortex↗
PubMed1979

"Incessant ovulation" and ovarian cancer.

A case-control study of 150 ovarian cancer patients under the age of 50 and individually matched controls was done to study the influence of fertility and oral contraceptive use on the risk of ovarian cancer. The risk decreased with increasing numbers of live births, with increasing numbers of incomplete pregnancies, and with the use of oral contraceptives. These three factors can be amalgamated into a single index of protection--"protected time"--by considering them all as periods of anovulation. The complement of protected time--viz., "ovulatory age", the period between menarche and diagnosis of ovarian cancer (or cessation of menses) minus "protected time"--was strongly related to risk of ovarian cancer. Other factors found to be associated with increased ovarian cancer risk were obesity, cervical polyps, and gallbladder disease. Women who had an "immediate" intolerance to oral contraceptive use had a fourfold increased risk of ovarian cancer. 7 patients, but no controls, could recall a family history of ovarian cancer.

Abortion, Spontaneous↗
PubMed1977

Problems in evaluating chronic toxicity of contraceptive steroids in dogs.

The long-term effects of oral contraceptive steroids including a combination of norethindrone and ethynylestradiol, a sequential regimen of dimethisterone and ethynylestradiol, and daily administration of megestrol acetate were studied in female beagle dogs at dose levels of 1, 10, or 25 times the projected human dose levels. The major findings included cystic endometrial hyperplasia and pyometra requiring hysterectomies and alopecia for the norethindrone-ethynylestradiol and dimethisterone-ethynylestradiol treated dogs. These groups did not have accentuated mammary development or treatment-related hyperplastic or neoplastic changes. For dogs given dimethisterone-ethynylestradiol, numerous acne-like lesions occurred in the skin of the mammary areas. Dogs given the higher dose levels of megestrol acetate had marked mammary stimulation, hyperplastic and neoplastic changes in the mammary glands, and clinical and pathologic changes typical of diabetes mellitus. Mammary changes of nodular hyperplasia, benign mixed tumor, and adenocarcinoma appeared as distinct entities although constant and intense mammary stimulation may be a common denominator. Such mammary changes have not been found in long-term studies in monkeys or rats with megestrol acetate, and the relevance of the canine mammary changes to projecting potential tumorigenesis in women is questioned.

Alopecia↗
PubMed1978

Effect of oral contraceptives on plasma androgenic steroids and their precursors.

Plasma dehydroepiandrosterone (DHEA), its sulfate ester (DHEAS), and androstenedione (A2), delta5-pregnenolone (delta5-P), and 17 alpha-hydroxypregnenolone were measured in women using estrogen-containing oral contraceptives and in female controls of similar age. All three androgenic steroids and their two C21 precursors were reduced in the oral contraceptive users compared with the controls. It is concluded that oral contraceptives cause a decrease in plasma DHEA, DHEAS, and A2, one possible mechanism for which is the inhibition of delta5-P synthesis from cholesterol.

17-alpha-Hydroxypregnenolone↗
PubMed1977

Effect of progestins on glucose and lipid metabolism.

Gestamimetic amounts of progesterone enhance basal and glucose-stimulated insulin production. Contraceptive doses of synthetic progestins cause a moderate increase or no change in glucose-stimulated insulin production, depending on route of administration and species tested. Estrogens potentiate the insulinotropic effects of progesterone and the synthetic progestins. Basal serum triglyceride concentrations are generally unaffected by progesterone or 17 alpha-acetoxyprogesterone treatment but may decrease during 19-nortestosterone administration. Glucose tolerance does not change during treatment with gestamimetic doses of progesterone alone but may improve in rats and monkeys during concurrent estrogen administration. By contrast, deterioration of glucose tolerance is observed in women treated concurrently with synthetic estrogen plus 19-nortestosterone derivatives and, occasionally, with 19-nortestosterone derivatives alone. No consistent changes in glucose metabolism have been observed after treatment with 17 alpha-acetoxyprogesterone derivatives alone. The cause of the species-related differences in glucose metabolism during 19-nortestosterone treatment is obscure.

Animals↗
PubMed1975

[Changes in heparinocytes during the administration of Depositon and Sequenz-Ovosiston].

During hormonal contraception with Deposiston (once a week pill) and with Sequenz-Ovosiston (14 days mestranol 0.1 mg, 7 days mestranol 0,08 mg and 2 mg chlormadinone acetate) doesn't take place a change of basophil granulocytes (heparinocytes) in blood. Under Deposiston the small elevation is somewhat lengthened, under Sequenz-Ovosiston the elevated phase is similar to those of the normal menstrual cycle. The smaller risk of thromboembolia under heparinocytopenia preventing contraceptives is discussed.

Agranulocytosis↗
PubMed1976

[Modification of the thrombocyte function using hormonal contraception. 1. Thrombocyte count, thrombocyte propagation and platelet aggregation under hormonal contraception].

The number of platelets, spreading and aggregation of platelets in plasma of 102 women treated with Ovosiston, an anticonceptive agent, were investigated. A significant increase of the number of platelets, spreading and aggregation of platelets was observed. Conclusions from isolated observations are not possible.

Adolescent↗
PubMed1976

Relations between fibrinogen degradation products and heparinocytes.

In the emergency reaction there is a short-time increase of the values of basophilic leukocytes in connection with normal values of fibrinogen degradation products (FDP). After diminuation of basophils FDP are to be detected. In the chronical ill and under different hormonal contraceptives these two processes are overlapped disturbing a unique negative or positive correlation of heparinocytes and FDP. Concerning the situation under standardized conditions or in single cases worthful conclusions are possible about compensation or decompensation of a latent disseminated intravascular coagulation.

Arterial Occlusive Diseases↗