Probable mode of action of oral contraceptives.
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The contraceptive effect of the new pill Ovysemn has been tested in two groups in a total of thirty-six patients. The preparation was well tolerated and the results failed to reveal fundamental differences in comparison with other trials performed by other investigators. No pregnancies occurred in either group.
The effects of oral contraceptive (OC) usage on platelet responsiveness to arachidonic acid metabolites was investigated. Platelets obtained from women who had been taking oral contraceptives for at least 3 months were compared with those of age-matched controls. Both the basal and prostacyclin (PGI2)-stimulated platelet cAMP levels were significantly lower in OC users than in non-users. There was no significant difference in the PGD2-stimulated cAMP levels between the two groups. Furthermore, platelet aggregability to U46619, a TXA2 agonist, was greatly enhanced by OCs. Our data suggests that OC usage can specifically enhance platelet responsiveness to TXA2 while suppressing platelet responsiveness to PGI2. Thus their overall effect would be a disruption of normal platelet responses in favour of thrombus formation.
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The contraceptive effect of oral contraceptive use provides an important health benefit, particularly in developing countries, where the risks of pregnancy and childbearing are increased. Several important noncontraceptive health benefits of oral contraceptive use include the prevention of endometrial and ovarian cancers. Data are generally reassuring concerning the risks of oral contraceptive use, which include cardiovascular disease and breast and cervical cancer.
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The growth hormone, insulin and blood glucose values were measured during a glucose tolerance test in 12 women before and after 3 months' use of a contraceptive of the sequential type (11 pills containing 0.05 mg D-norgestrel and 0.05 mg ethinylestradiol and 10 pills containing 0.125 mg D-norgestrel and 0.05 mg ethinylestradiol). Neither fasting blood glucose nor glucose tolerance are altered during administration of the contraceptive steroids. On the other hand, the reactive insulin level is significantly increased in comparison to the basal value, thus showing the signs of hyperinsulinemia. Both the gestagens and the estrogens appear to contribute to this disturbance of insulin secretion. Presumably the hyperinsulinemia is an expression of decreased sensitivity of the peripheral tissue to insulin. The growth hormone, a so-called insulin antagonist, is not responsible for the "insulin resistance" observed. The values measured by us after administration of the contraceptive do not significantly differ from the basal values.
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