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Oral contraceptive use and fibrocystic breast disease of different histologic classifications.

The relationship between oral contraceptive (OC) use and occurrence of fibrocystic breast disease (FBD) of different histologic classifications was evaluated with data from a cohort study. Biopsy specimens from 232 women with FBD were classified into different atypia categories. In 96 matched pairs of OC users and nonusers, atypia scores were lower in users than in nonusers. Women without breast diseases (500 OC users and 500 nonusers) were sampled from the original cohort to form a two-stage "anamorphic" study with the 232 cases of FBD. The previously shown inverse association between OC use and FBD occurrence was present and increased with increased length of OC use. However, the "protective effect" of OC use did not vary for different histologic classifications of FBD. The findings from both paired and anamorphic analyses of the data are not consistent with the hypothesis that the use of OC is associated with decreased frequency only of FBD with minimal epithelial atypia.

Adult↗

More about natural family planning.

When properly taught and practised, natural family planning can be a highly effective form of birth regulation. Recent studies indicate low failure rates of less than three pregnancies per 100 women years for couples with a strong motivation to follow the method. Studies show that pregnancy rates are high when the rules for avoiding pregnancy are not adhered to. Successful natural family planning can lead to heightened self esteem and marital enrichment.

Amenorrhea↗

Combined use of clomiphene and intranasal luteinizing hormone-releasing hormone for induction of ovulation in chronically anovulatory women.

Combined therapy with clomiphene and intranasal luteinizing hormone-releasing hormone (LHRH) was used to induce ovulation in eight chronically anovulatory patients under treatment for infertility. Clomiphene, 100 mg daily, was given from the 5th to the 9th day of the cycle. Synthetic LHRH was administered intranasally in different dosages from day 11 to day 14, in an attempt to induce late follicular development and ovulation. Five of the eight patients ovulated, and three conceived. The success achieved with combined clomiphene and intranasal LHRH administration suggests a therapeutic potential in the management of anovulatory infertility.

Administration, Intranasal↗

[Pathophysiology of gonadotropin secretion in patients with idiopathic precocious puberty and follow up studies during and after therapy with medroxyprogesterone acetate (author's transl)].

In order to assess the pathophysiology of gonadotropin secretion in patients with idiopathic precocious puberty, responses of LH and FSH to LH-releasing hormone (LH-RH), clomiphene citrate (Clomid) and medroxyprogesterone acetate (Deop-provera) in 6 female patients were tested. The basal levels of serum LH and FSH were elevated in 4 of 6 patients and enhanced LH response to 100 mug of intravenous LH-RH was observed in 5 patients, while FSH response was comparable to that of prepubertal subjects. Administration of Clomid (50 mg) for 7 days provoked LH increase in 3 out of 6 patients in contrast to no LH change found in normal prepubertal girls. while FSH levels decreased in 3 out of 6 patients. Intramuscular injection of Depo-Provera (100 mg) reduced LH and FSH levels in 4 patients. The Depo-Provera therapy in a dose of 75 approximately 225 mg every two weeks, caused suppression of breast development and menstrual bleeding but the prevention of growth spurt and bone age maturation were insufficient. Basal body temperature charts in 2 patients showed an ovulatary pattern immediately following cessation of Provera therapy of more than 8 years' duration. In conclusion, it is suggested that 1) function of hypothalamo-pituitary-ovarian system in patients with idiopathic precocious puberty is similar to that of normal pubertal subjects, 2) therapeutic doses of Depo-Provera, enough to suppress the patients' secondary sex characterics, was not sufficient to control bone age maturation 3) it is necessary to follow up patients more closely by measuring serum levels of gonadotropin and estrogen during the course of therapy.

Child↗

Lack of correlation between contraceptive pills and Down's syndrome.

A case-control study has been made on the use of oral contraceptives before pregnancy and the birth of an infant with Down's syndrome. Controls were matched for age and parity and selected from the Medical Birth Register. Information on Pill usage was obtained from the Swedish standardized maternity health record which contains dates for when the women stopped using the Pill and for last menstrual period. There was no indication of any relation between the use of oral contraceptives and Down's syndrome.

Adolescent↗

Blood changes in sex steroid hormone users. Circulating immune complexes induced by estrogens and progestogens and their relation to vascular thrombosis.

Oral contraceptives (OC) have been shown to induce in some women antiethinylestradiol antibodies which may be detected as circulating immune complexes by precipitation in ammonium sulphate at 25% saturation (CIC.AS). A reevaluation of the presence of CIC.AS in 644 women either receiving sex steroid hormones or not was made, and the respective role of estrogens and progestogens investigated, together with the influence of the dose. The study confirmed that CIC.AS levels were significantly different in controls (442 +/- 246 micrograms/ml serum), healthy gonadal hormone users (754 +/- 700 micrograms) and users with thrombosis (1331 +/- 1099 micrograms/ml). These results indicated that: 1. CIC.AS could be induced by synthetic estrogens as well as progestogens, but not by non-synthetic hormones; 2. the induction of CIC.AS seemed poorly dose-related, and 3. was not correlated with the duration of use; 4. in reactive women, high CIC.AS levels occurred as soon as 3 weeks after the beginning of synthetic gonadal hormones use, persisted throughout treatment and decreased slowly when discontinued; 5. in women with thrombosis CIC.AS were more frequently detected (64.7%) than in healthy users (32.2%) P less than 0.001. The importance of the immunologic changes as a risk factor in thrombosis in OC users was evaluated in comparison with other predisposing factors and tobacco smoking.

Adolescent↗

Effect of long-term hormonal contraception on plasma lipids.

Serum lipid and apoprotein levels were determined in fasting women after long-term use (5-12 years) of Depo Provera, Orgametril, Ortho Novum SQ, Binordiol, Microgynon-50, and Ministat. Compared with matched controls, pure progestogens (Depo Provera and Orgametril) caused a moderate decrease of TG, HDL chol, and Apo A1, whereas estrogen-dominant oral contraceptives (Ortho Novum SQ) increased the same parameters. The effects of long-term use of hormonal contraception on lipids did not differ from those predicted from short-term (6 months) studies.

Adult↗

Regulation of non-pregnant human uterine contractility. Effect of antihormones.

Uterine contractility was recorded on cycle day LH+6 to LH+8 in a control and treatment cycle in 14 healthy non-pregnant volunteers. In the treatment cycle the subjects received either 50 mg of the antiprogestin RU 486 daily for three days or 40 mg of the anti-estrogen tamoxifen daily for two days. The treatment started on day LH+2. During the recording, 2 to 5 micrograms PGF2 alpha was administered into the uterine cavity. The plasma levels of progesterone and estrogen were the same in both the control and treatment cycles. RU 486 caused a significant increase in uterine contractility expressed in Montevideo Units (MU) and a decrease in uterine tonus in comparison with corresponding data obtained in the control cycle. Following treatment with tamoxifen, uterine contractility was lower but the difference was not significant. PGF2 alpha invariably caused a stimulation of uterine contractility. However, treatment with the antihormones did not influence the response. The result of the present study indicates that the change in uterine contractility occurring in the latter part of the menstrual cycle and during menstruation is due to progesterone withdrawal.

Adult↗

Effects of two low-dose oral contraceptives on serum lipids and lipoproteins: differential changes in high-density lipoprotein subclasses.

Oral contraceptives containing DL-norgestrel or norethindrone with ethinyl estradiol were administered by random assignment to 21 menstruating women, matched for anthropometric measurements, age, diet, alcohol consumption, smoking, and exercise habits. Pretreatment and 7-week treatment blood samples were obtained and assayed for serum cholesterol, triglyceride high-density lipoprotein cholesterol (HDL-C), and total high-density lipoprotein (HDL), HDL2a, HDL2b, and HDL3 subclasses by analytic ultracentrifugation. Subjects using the norethindrone oral contraceptive had a significant increase in HDL-C: baseline, 46 mg/dl; 7 weeks, 51 mg/dl. Values for the subjects using the norgestrel oral contraceptive were not significantly changed: 46 and 44 mg/dl, respectively. Users of the norethindrone oral contraceptive had significant elevations of total HDL and HDL3, while norgestrel oral contraceptive users demonstrated no significant changes. HDL2b increased with the norethindrone oral contraceptive and declined with the norgestrel oral contraceptive. The changes in HDL2b from baseline to treatment were not significant (p greater than 0.05), but the change with the norethindrone oral contraceptive did differ significantly from that with the norgestrel oral contraceptive (p less than 0.02). These changes may indicate oral contraceptive-induced alterations in HDL structure and metabolism that could be related to the risk of development of atherosclerosis.

Adult↗

Experiences with a tampon-spermicide device.

A tampon applicator is described in which a spermicidal solution is stored in the plunger and released into a disposable tampon just prior to insertion of the tampon. The experiences of 26 volunteers who used the device at the time of coitus suggest that the method is both acceptable and feasible, although four of the ten subjects attempting tampon removal by themselves experienced some difficulty. Postcoital studies of the cervical mucus near the time of ovulation were conducted on 16 subjects and no motile spermatozoa were found. This suggests a high degree of theoretical effectiveness.

Contraceptive Devices, Female↗

Effect of levonorgestrel contraceptive implants, Norplant, on blood coagulation.

A longitudinal study of coagulation parameters was carried out on 47 women using the levonorgestrel subdermal implants, NORPLANT. The study comprised measurement of platelet count, prothrombin time, thrombin time, partial thromboplastin time with kaolin, clotting factors I, II, V and VI through XIII, plasminogen, antithrombin III (AT III), alpha 1 antitrypsin, alpha 2 macroglobulin and fibrinogen degradation products. The tests were done at admission and after one, three and six months of NORPLANT use. Parallel and similar studies were done on two groups of oral contraceptive users; the first group used a pill containing 1 mg norethisterone and 50 micrograms mestranol, and the second a pill consisting of 150 micrograms levonorgestrel and 30 micrograms ethinylestradiol. Results from this ongoing study have indicated that women using NORPLANT implants evidenced lack of effects on most of the parameters tested except for factor VII activity which was increased and AT III concentration which was decreased after six months of use. The combined pill users evidenced marked changes in the platelet count, the screening tests and in most of the coagulation-promoting factors; the changes were apparent after three months of use and became more pronounced after six months. The results demonstrate, with marked contrast, that the implants had less pronounced effects on the blood coagulation system than did the combined pills used in this study.

Adult↗

Measurement of ethynylestradiol and levonorgestrel incorporated into sustained release contraceptive formulations.

High performance liquid chromatography was used to measure the concentrations of ethynylestradiol (EE) and levonorgestrel (LNG) released from contraceptive devices into aqueous medium containing the cationic detergent, benzalkonium chloride. Most of the detergent was removed after solvent extraction of the steroid, although small amounts of it remained in the steroid phase. Over the course of many injections into octasilyl (C8) or octadecylsilyl (C18) reversed-phase columns, the chromatographic profile of EE was gradually altered with multiple peaks emerging. The profile of LNG was not changed. EE chromatographed as a double peak on a fully end-capped C18 column. Rechromatography of each peak yielded a mixture of the two. Mass spectral analysis showed that the peaks differed only in the gain or loss of an equivalent of water. Introduction of a cation exchange column before the analytical column removed residual benzalkonium ions, and by thus preventing deterioration of the column, permitted EE to consistently emerge as a single, symmetrical peak.

Chromatography, High Pressure Liquid↗

Assessment of a new spermicidal agent against ejaculated dog and human spermatozoa in vitro.

The spermatostatic potencies of a new vaginal contraceptive agent, RS-37367, and a standard surfactant compound, nonoxynol-9, have been compared by using ejaculated dog and human spermatozoa. RS-37367 was 25 to 50 times more potent than nonoxynol-9 against dog spermatozoa. Nonparallel concentration-response lines were obtained against human spermatozoa. Concentrations of RS-37367 causing immediate spermatostasis against dog spermatozoa resulted in vesiculation of the plasma and outer acrosomal membranes of spermatozoa; similarly, immediately spermatostatic concentrations of nonoxynol-9 were associated with the previously documented generalized membrane stripping. The activities of both RS-37367 and nonoxynol-9 were affected by the concentration of dog spermatozoa in semen-compound mixtures. Short-term (5-minute) exposure of spermatozoa to concentrations of RS-37367 not immediately spermatostatic resulted in progressive immobilization of spermatozoa. Extensive washing of the spermatozoa was not able to reverse this effect, in contrast to spermatozoa transiently exposed to nonoxynol-9.

Animals↗

Breast feeding.

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Animals↗

Serum apolipoprotein A-I levels: relationship to lipoprotein lipid levels and selected demographic variables.

Serum apolipoprotein A-I (apo A-I) and lipoprotein cholesterol and triglycerides were measured in 289 persons randomly selected from a Northern California industrial population in 1974-1976. Apo A-I and high density lipoprotein (HDL) cholesterol were strongly correlates with one another and both were inversely correlated with very low density lipoprotein (VLDL) triglycerides. The decrease in HDL-cholesterol with increasing VLDL-triglycerides was relatively much larger than the concomitant decrease in apo A-I. The relative decrease in the sum of cholesterol and triglycerides in the HDL fraction was similar to that for apo A-I, suggesting that the decreasing HDL-cholesterol:apo A-I ratio with increasing VLDL-triglycerides is due in large part to reciprocal transfer of cholesteryl esters for triglycerides between HDL and VLDL. Mean apo A-I level was 16 mg/dl higher in women not taking exogenous sex steroids than in men, 31 mg/dl higher in women taking estrogens without progestins and 10 mg/dl higher in contraceptive drug users than in other women, and 8 mg/dl higher in black than in white men. The first two of these differences were statistically significant. Apo A-I level was unrelated to age, but increased with ethanol consumption and decreased with adiposity. An inverse relationship between Apo A-I and cigarette smoking was found among women.

Adult↗