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Possible antidepressant effect of oral contraceptives: case report.

An oral contraceptive was used successfully to treat recurrent premenstrual depressions and a subsequent major depressive episode in a 20-year-old woman. The relationship between premenstrual and major depressions is explored and the overlapping CNS effects of gonadal steroids and classical antidepressants are discussed.

Adult↗

Pathologic effects of oral contraceptives.

The pathologic effects of oral contraceptives have been described in this paper and in other reviews [1, 5, 23, 35, 44, 48, 59, 80, 103, 114]. Approximately 10 million women currently use oral contraceptives in the United States. These drugs are beneficial both to the users and for population control. It is their effect on the health status of women who take them that must continue to have well-organized investigation so that more meaningful conclusions concerning their safety will permit continued use. In some instances, the pathologic effects of oral contraceptives make it necessary that new methods of contraception be found. Intensive research in this area is needed and judiciuos use of oral contraceptives must be maintained. A national registry should be formed to record and investigate the cases of women who die or have adverse reactions while taking these agents. A registry might identify associations no previously known to exist in patients taking oral contraceptives. It would serve to concentrate the data in one area so that more material would be available for the study of pathogenetic mechanisms. It would heighten patient and physician awareness of the untoward effects and increase the responsibilities of the women who take them to monitor their own health.

Blood Glucose↗

Decreased risk of symptomatic chlamydial pelvic inflammatory disease associated with oral contraceptive use.

Studies have shown that oral contraceptive use may protect against pelvic inflammatory disease (PID), but it is not known whether oral contraceptives protect against the disease among women already infected with Chlamydia trachomatis or Neisseria gonorrhoeae. The relationship between oral contraceptive use and PID was analyzed in a case-control study of 141 women with verified PID and 739 randomly selected, sexually active women with no clinical evidence of the disease. Case and control subjects were stratified on the basis of infection with C trachomatis, N gonorrhoeae, or neither organism. Among women infected with C trachomatis alone, those with PID were less likely than control subjects to use oral contraceptives. The association was significant when oral contraceptive use was compared with nonuse (odds ratio, 0.22; 95% confidence interval, 0.08 to 0.64) and with noncontraception (odds ratio, 0.17; 95% confidence interval, 0.06 to 0.53) and remained so after adjusting for potential confounding variables by logistic regression analysis. Among women infected with N gonorrhoeae alone, no association was found between use of oral contraceptives and PID. These data suggest that oral contraceptive use protects against symptomatic PID among women infected with C trachomatis but not among those infected with N gonorrhoeae.

Adolescent↗

[Effects of second and third generation oral contraceptives on hemostasis].

Use of oral contraceptives induce changes in haemostatic parameters: changes occur in the procoagulant, anticoagulant, and fibrinolytic systems. The increased risk of venous thromboembolism with use of third, as compared with second generation oral contraceptives, found in epidemiological studies, has stimulated new research in haemostatic changes induced by both generations of oral contraceptives. A randomized crossover study showed that use of the third generation pill caused a greater increase of factor VII and prothrombin and a more pronounced decrease of factor V than the second generation pill. Acquired resistance to activated protein C (APC) was induced more strongly by preparations of the third than by those of the second generation. The concentration of protein S decreased markedly exclusively during use of the third generation pill, while it did not change during use of the second generation pill. The oral contraception-related effects on the anticoagulant system strongly resemble those of some forms of hereditary thrombophilia. If a woman with hereditary APC resistance (caused by factor V Leiden) uses oral contraceptives as well, and especially when she uses those of the third generation, she is subject to a considerable increase of the risk of venous thrombosis and becomes even more resistant to the anticoagulant action of protein C. In view of the epidemiological backgrounds of the difference in risk of thrombosis between second and third generation contraceptives, the second generation pill is recommended as the first choice for oral contraception.

Activated Protein C Resistance↗