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PubMed1986

Abnormal endocrine profile among women with confirmed or presumed ovulation during long-term Norplant use.

FSH, LH, estradiol and progesterone were serially assayed during 8 cycles of six subjects using six subdermal implants releasing levonorgestrel (NORPLANT) for a period of 2 to 6 years. All 8 cycles studied had a very low LH peak and a low or nonexistent FSH peak as compared to 8 control cycles. The mean LH peak for NORPLANT users was 33.9 mIU/ml as compared to 142 mIU/ml in the control group; and FSH was 13.0 mIU/ml as compared to 31.3 mIU/ml in controls. A subsequent rise in progesterone was observed in the 8 cycles studied, but the mean mid-luteal levels were significantly lower than in controls (9.0 ng/ml vs. 15.6 ng/ml). No differences were observed in the estradiol curve. Two of the subjects using NORPLANT had a laparotomy performed on days 17 and 20 of the cycle, for surgical sterilization purposes. A distinctive corpus luteum with a stigma was observed. Our results indicate that women under prolonged use of NORPLANT do not have normal endocrine cycles, even though they may ovulate. It is doubtful however, that these ovulatory cycles can be fertile under the abnormal endocrine conditions found in our subjects. In addition to the possible effect of luteal insufficiency, the normal maturation of the oocyte may be impaired.

Adult↗
PubMed1983

Comparison of haematological indices between women of four ethnic groups and the effect of oral contraceptives.

Six-hundred-and-eighty-two women volunteers from four ethnic groups--Black, Indian, Oriental and White took part in a study to assess differences in haematological indices between the groups. This study was part of a broad investigation into the metabolic effects of oral contraceptives. The effect of the oral contraceptive (OC) on haematological indices was analysed but not found to be significant. The haemoglobin concentrations were lower than normal laboratory reference values for White subjects in 12.5% of Indian, 16.5% of Black and 4.3% of Oriental control groups respectively. All the White control group were within the normal range. These findings were considered in relation to age, weight, pregnancies, smoking, alcohol consumption, nutritional status, and disorders of haemoglobin synthesis. A deficient iron intake accounted for the high incidence of low haemoglobin in the Indian group in whom low transferrin saturation and serum ferritin were observed. With the possible exception of inherited disorders of haemoglobin synthesis, none of the factors we considered could account for the low haemoglobins found in the Black group. Separate reference values for haematological indices in different ethnic populations are considered.

Adolescent↗
PubMed1985

The influence of oral contraceptives on the postmolar human chorionic gonadotropin regression curve.

This article reports a retrospective analysis of 149 evaluable cases of molar pregnancy managed at Women's Hospital, Los Angeles County/University of Southern California Medical Center, from January 1977, through June, 1983. In the 84 cases prior to 1981, the patients received estrogen-progestogen oral contraceptives after evacuation while the 55 patients seen after that used nonhormonal contraceptives. The frequency of abnormal regression of the serum beta-subunit of human chorionic gonadotropin in the two groups was not significantly different (22.6% in the hormonal contraception group versus 34.5% in the nonhormonal contraception group). The groups were compared for known and potential risk factors and were nearly identical with respect to patient age, parity, maternal blood type, and race. There were also no significant differences with respect to uterine size, preevacuation beta-subunit of human chorionic gonadotropin serum titer greater than 100,000 mIU/ml, and frequency of theca-lutein cysts. Gestational age was significantly shorter and the frequency of cases with a preevacuation beta-subunit of human chorionic gonadotropin serum titer greater than 250,000 mIU/ml significantly higher in the nonhormonal contraception group, indicating that the nonhormonal contraception group had a higher risk for abnormal human chorionic gonadotropin regression than the hormonal contraception group. We conclude that this study provides no evidence that the use of estrogen-progestogen oral contraceptives prior to human chorionic gonadotropin remission increases the risk for invasive mole or choriocarcinoma following molar pregnancy.

Adult↗
PubMed1984

The effect of different contraceptive treatments on the serum concentration of dehydroepiandrosterone sulfate.

Twenty-six healthy, non-hirsute women had antecubital venous blood obtained before and during treatment with various contraceptive steroids for the measurement of dehydroepiandrosterone sulfate (DHEA-S). Six of the women were randomized to receive Ortho Novum 1/35 (O/N), 7 were assigned to Ovcon 35 (OV), and another five received Nordette (N). The 6 women ingesting O/N as well as the 7 receiving OV had significant decreases in serum concentrations of DHEA-S (p less than 0.05). The percentage of decrease in DHEA-S in the O/N group (39 +/- 6%) and in the OV group (30 +/- 5%) was not statistically different. The group receiving N showed no changes from baseline measurements. Serum samples from another 8 women who had received subcutaneous implants of levonorgestrel (1-Ng) were obtained. No significant changes occurred in serum DHEA-S between baseline and six-month samples. The data that 1-Ng alone and the combination of 1-Ng and ethinylestradiol did not change DHEA-S levels suggest that 1-Ng does not affect adrenal androgen secretion. Because N, O/N and OV contain similar quantities of ethinylestradiol, these results indicate that norethindrone, but not 1-Ng, has a major suppressive effect upon adrenal androgen secretion.

Adolescent↗
PubMed1986

Comparative effects of monophasic desogestrel plus ethinyloestradiol and triphasic levonorgestrel plus ethinyloestradiol on lipid metabolism.

The effects of the monophasic oral contraceptive preparation desogestrel plus ethinyloestradiol (EE) and triphasic levonorgestrel plus EE on lipid metabolism were compared. Sixteen young healthy female volunteers received monophasic desogestrel plus EE (21 X 150/30), whereas eighteen women received triphasic levonorgestrel plus EE (6 X 50/30 + 5 X 75/40 + 10 X 125/30) for six consecutive cycles. The lipid composition of the various lipoprotein fractions was estimated after separation in a density gradient by ultracentrifugation. In addition, the apolipoproteins A-I and B were assessed. HDL-cholesterol (precipitation method), HDL-2 cholesterol, HDL-2 phospholipids and the ratio apolipoprotein A-I to apolipoprotein B were significantly higher in the monophasic desogestrel group than in the triphasic levonorgestrel group after three and six treatment cycles. HDL-cholesterol (gradient), HDL-phospholipids (gradient), HDL-3 phospholipids and apolipoprotein A-I were only significantly higher after six treatment cycles. No differences between the groups were observed for the other lipid variables studied including triglycerides and VLDL-triglycerides.

Adult↗
PubMed1984

Effect of oral contraception on serum bile acid.

Eighteen normal women, 20 with active urinary schistosomiasis, and 25 with past histories of viral hepatitis were given a contraceptive pill containing 0.05 mg ethinyl estradiol and 0.5 mg levonorgestrel for six consecutive cycles. Serum bile acid levels were measured by enzyme immunoassay method before and after 3 and 6 months of use. Simultaneously, conventional liver function tests (serum bilirubin, transaminases, alkaline phosphatase and albumin) were done. Serum bile acid concentration was not significantly changed by the contraceptive use in any group. The concentration of cholylglycine (the main bile acid measured) did not correlate with the values of any of the other tests. Pretreatment values of serum cholylglycine were significantly lower in the past-hepatitis group. The difference was maintained during treatment.

Alanine Transaminase↗
PubMed1983

Vasospasm following transsphenoidal tumor removal associated with the arterial changes of oral contraception.

A case of fatal cerebral vasospasm after transsphenoidal removal of a pituitary macroadenoma with suprasellar extension is reported. On the second postoperative day the patient developed headache, lethargy, and cardiorespiratory arrest. Five days later, after recovery from this episode, she developed signs of involvement of the left hemisphere. At that time she demonstrated severe cerebral vasospasm, which was worse in the left supraclinoid segment of the internal carotid artery, and she died 19 days postoperatively. Postmortem examination showed left hemispheric and hypothalamic infarction with subsequent herniation. In addition, pathologic arterial changes usually related to use of oral contraceptives were present.

Adenoma↗
PubMed1983

Effects of daily 30 mcg d-norgestrel on growth hormone and cortisol.

The effects of d-norgestrel on serum growth hormone and cortisol were determined in 9 healthy Thai women, who took 30 mcg d-norgestrel tablet daily for 12 months. Growth hormone (both fasting and during OGTT) and morning cortisol concentrations were measured before and after 6 and 12 months. It was found that growth hormone concentrations tended to decrease but were not statistically significant. Patterns of growth hormone in relation to glucose and insulin measured during OGTT were similar throughout the study. The morning cortisol values slightly increased after treatment. The limited data from this study suggested that d-norgestrel, at the daily dose of 30 mcg, did not significantly alter serum growth hormone and cortisol levels in the group of Thai women after one year's time of use.

Adult↗
PubMed1984

Influence of psychosocial factors on adolescent compliance with oral contraceptives.

This paper prospectively tests the influence of a variety of sociomedical and psychosocial factors on compliance with oral contraceptives among adolescent females from a population at high risk for pregnancy. Fifty-six females aged 14-19 yr from a lower socioeconomic background received a battery of pretest measurements and were then given Ortho-Novum 1/35 combined with riboflavin during an initial visit and 1-, 2-, and 4-month follow-ups. Compliance was measured at each follow-up using a Guttman scale consisting of: (1) avoidance of pregnancy, (2) appointment adherence, (3) pill count, and (4) urinary fluorescence for riboflavin. Six factors were found to be significantly associated with noncompliance: (1) multiple sexual partners, (2) appointment being made by the adolescent, (3) low evaluation of personal health, (4) feelings of hopelessness, (5) worry about becoming pregnant, and (6) previous abortion. These findings suggest that certain indicators of sexual activity and social psychological status may help predict noncompliance in some adolescent females.

Adolescent↗
PubMed1985

[Hemichorea and oral contraceptives].

A 26 year-old woman presented with a left hemichorea while taking oral contraceptives (a combination of ethinyl-estradiol and norethisterone). There was marked improvement of the choreic movements after discontinuation of the oral contraceptive and complete resolution by 6 weeks. Induction of chorea is a rare complication of oral contraceptives. The possible mechanisms are briefly reviewed.

Adult↗
PubMed1982

Effect of topically applied adrenergic blockers on fertility.

The contraceptive properties of two adrenergically active drugs, propranolol and reserpine, were measured in vivo and in vitro. Propranolol became effective as a spermicide for human sperm at a concentration of about 2 x 10(-3) M and for rat sperm at 2 x 10(-2) M. Reserpine was also more effective on human than rat sperm and about 20 times less effective than propranolol. Both propranolol and reserpine prevented implantation when instilled into the uteri of rats. The anti-implantation effect persisted for up to 5 days after instillation of propranolol. When freely breeding rats eventually became pregnant after daily vaginal instillation of propranolol, the number of uterine implantations decreased as the concentration of vaginally instilled propranolol increased. The implantations tended to be toward the fundal end of the uteri, away from the source of propranolol, thus indicating a topical rather than a systemic anti-implantation effect.

Animals↗
PubMed1982

Long acting injectable hormonal contraceptives.

Injectable hormonal preparations can be highly effective and satisfactory contraceptives. The two main preparations available today are depot medroxy progesterone acetate (DMPA) and norethisterone oenanthate (NET-OEN), but several other approaches are currently under clinical trial. Injectable contraceptives have some unique advantages which give them justifiably wide appeal amongst many groups of women. However, they do have a number of disadvantages including invariable menstrual disturbance and a delay in the return of fertility. One formulation of DMPA, Depo-Provera, is probably the most extensively investigated single hormonal contraceptive ever made. These studies indicate that it is remarkably safe and does not face any more unresolved issues than the combined pill, intrauterine device or tubal sterilization. However, for a number of disparate emotional and political reasons it has attracted the attention of several consumer and feminist groups, who have waged a prolonged and quite unjustified campaign against it. It is to be hoped that future debate will be conducted on a more informed, rational and less emotional basis. Injectable contraceptives should have an important place in the family planning armamentarium of all countries, and current developments should lead to a decrease in concerns about presently available agents. This should further increase the widespread acceptability of this approach to contraception.

Animals↗