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PubMed1995

Sequential gonadotrophin-releasing hormone agonist/low-dose oral contraceptive treatment for leiomyomata uteri.

On the basis that gonadotrophin-releasing hormone agonists (GnRHa) induce a significant but transient shrinkage of leiomyomas and that oral contraceptive use may be associated with a decreased risk of fibroids, we tested the hypothesis that sequential GnRHa/low-dose oral contraceptive treatment could be a therapeutic alternative in perimenopausal women with uterine fibroids. Six premenopausal women with leiomyomata uteri were treated with D-tryptophan-6-luteinizing hormone-releasing hormone (D-Trp-6-LHRH) depot (Decapeptyl 3.75) for 6 months and demonstrated a significant reduction in mean uterine volume. A low-dose oral contraceptive containing 30 micrograms of ethinyl oestradiol plus 150 micrograms of desogestrel was given during the ensuing 12 months. When GnRHa therapy was discontinued, there was a rapid regrowth of the uterine fibroids and the uterine volume had reached, or even exceeded, pretreatment values by the eighth to 12th month of contraceptive therapy. Sequential GnRHa/low-dose oral contraceptive treatment is not a useful tool for leiomyomata uteri.

Adult↗
PubMed1977

Endometrial carcinoma in women under 40 years of age: comparison of cases in oral contraceptive users and non-users.

Women under 40 years of age rarely develop carcinoma of the endometrium, this age group comprising less than 3% of all cases in most large series. The Registry for Endometrial Carcinoma in Young Women Taking Oral Contraceptive Agents has recorded and studied 30 cases in women under 40 with a history of oral contraceptive administration, and these are compared with 25 cases in the same age group which were accessioned at the Armed Forces Institute of Pathology prior to the era during which these agents have been available, and with series reported in the literature totaling 137 cases with no contraceptive history. In the first group, special attention is paid to the 20 women who received sequential agents exclusively or predominantly, since the association with these agents (primarily Oracon) is much higher than would be expected from the fact that less that 10% of oral contraceptives used in this country are of the sequential type. An analysis of the three groups reveals a similar incidence of the various histologic types (primarily well differentiated tumors with a relatively favorable prognosis), the only difference being the presence of secretory features in 14 of 29 oral contraceptive users vs. only two of 25 women not taking these agents. Clinical and pathologic staging were also predominantly favorable, and comparable in all groups. There were, however, notably higher incidences of nulliparity, obesity, and sclerocystic ovaries--all features traditionally associated with endometrial carcinoma--in the patients not receiving oral contraceptives or receiving combined agents, suggesting that the group receiving sequentials may not represent the same constitutionally predisposed population. Only three of 55 women among our personally reviewed cases have thus far died of cancer (one in the contraceptive group and two in the non-user group) and all three of these had poorly differentiated tumors with myometrial invasion. The excellent prognosis for most patients in this age group is thus confirmed.

Adenocarcinoma↗
PubMed1980

Incidence of endometrial cancer in relation to the use of oral contraceptives.

Female residents of King and Ierce Counties in the state of Washington in whom endometrial cancer was diagnosed during 1975--77 were interviewed concerning prior use of oral contraceptives. Their responses were compared with those of a random sample of women from the same population. Women who had taken Oracon (0.1 mg of ethinyl estradiol and 25 mg of dimethisterone) were estimated to have a risk of endometrial cancer 7.3 times that of other women (P = 0.007). This elevation in risk was not seen in users of other sequential preparations. Women who had used combined oral contraceptives had only 50 per cent of the incidence of endometrial cancer of nonusers (P = 0.05), although the protective effect was not evident among those who subsequently took menopausal estrogens for more than two years. These associations suggest that development of neoplasia in the endometrium can be extremely sensitive to hormonal factors: if an oral contraceptive, like Oracon, emphasizes the estrogenic component, promotion of cancer can result; if like combined preparations, the contraceptive emphasizes the progestational component, protection against cancer can result.

Adult↗
PubMed1976

Post-pill anovulation.

Basal temperature records were maintained by 346 women after ceasing to take oral contraceptives; 167 had ceased using combined and 179 had ceased using low-dose sequential formulations. In the first cycle after withdrawal of low-dose sequential pills, 11 (6%) women failed to ovulate and ovulation was delayed in five cases. Short luteal cycles occurred in 14 subjects. In 83% of the subjects there was no disturbance of ovulation. In the first cycle after withdrawal of combined oral contraceptives, 49 (30%) women failed to ovulate and ovulation was delayed in 29 cases. A short luteal phase was observed in 26 subjects. In only 38% of the subjects was there no disturbance of ovulation. The minimal disturbance to ovulation in the cycle after the withdrawal of low-dose sequential formulation indicates that this type of oral contraceptive carries little risk of producing post-pill infertility. Women under the age of 21 years were anovulatory nearly twice as frequently as older women after ceasing to use combined oral contraceptives.

Adolescent↗
PubMed1990

[Oral contraception].

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Contraceptives, Oral, Combined↗
PubMed1977

[Structure and ultrastructure of the endometrium with the depot contraceptive Depositon].

Endometrium was investigated histologically in 55 fertile women and by electron-microscope in 6 women under the influence of Deposiston (Jenapharm), a sequential contraceptive containing a long acting oestrogen--ethinyloestradiolsulfonate. The drug was administered orally in 1 mg doses on the 5., 12. and 19. day of each cycle. To achieve proper withdrawal bleeding a single oral dose of 10 mg norethisteronacetate was given on the 26. day of the cycle. Whereas Sequenz- Ovosiston (Jenapharm), a "classical" sequential preparation causes only insignificant variations from the physiological endometrium of fertile women, Deposiston developes irregularly proliferated patterns in more than 50% of the patients, due to differences of the elimination rate of ethinyloestradiolsulfonate. The degree of proliferation covers a wide range from a slightly proliferated endometrium to changes similar to hyperplasia of the endometrium with cystically enlarged glands. The secretory transformation takes place 2 or 3 days following the progestogen application. In 2 of the cases a secretory pattern could be found several days before the intake of the progestogen. This indicates break-through-ovulations.

Adult↗
PubMed1979

Do anticonvulsants reduce the efficacy of oral contraceptives?

Women in our area with epilepsy who were also taking oral contraceptives were identified. Of 82 patients taking oral contraceptives, 41 had used both anticonvulsants and oral contraceptives for a total of 955 months. Three documented oral contraceptive (pill) failures occurred during this period, whereas the expected number of 0.12 (relative risk, 25; 95% confience interval, 5 to 73). No pill failures were observed in 2,278 months among women with epilepsy who were taking oral contraceptives but who were not taking anticonvulsants at this time. Thus our data support the suggestion that there is an increased rate of pill failure among women taking anticonvulsants. In view of this diminished effectiveness, the advisability of using oral contraceptives rather than one of the other forms of contraception when anticonvulsant medication is being used concurrently may need to be reevaluated.

Anticonvulsants↗
PubMed1980

Immune reactivity of women on hormonal contraceptives. Phytohemagglutinin and concanavalin-A induced lymphocyte response.

To investigate the influence of sex-steroids on the in vitro correlate of cell-mediated immunity (CMI), blood samples from 49 women on hormonal contraceptives were tested on the lymphocyte response to the mitogens phytohemagglutinin (PHA) and concanavalin A (Con-A). Sixteen women were taking oral contraceptives of combined oestrogen/progestogen of the same brand (low oestrogenic and middle range progestogenic activity); 15 had received intramuscular injections of medroxyprogesterone acetate and 18 women were using a sequential pill. The results were compared with those of 18 women not taking contraceptive steroids and matched for age. No significant changes were observed between the different groups. Considering the previously found alterations in dinitrochlorobenzene (DNCB) skin test reactivity by sex steroids, it is hypothesized that sex-steroids have little or no influence on the central proliferative phase of the immune response, but have a profound effect on the efferent phase.

Adolescent↗
PubMed1975

[Radioimmunologic studies on serum gonadotropic hormones during oral contraception].

In 10 women serum FSH- and LH-concentrations (radioimmunoassay) were measured daily throughout a complete cycle. 2 patients exhibited untreated biphasic menstrual cycles. 2 women were under the treatment of a combined estrogen - progestagen preparation, 1 woman was taking a sequential preparation, and 5 patients were treated with a weekly dose of a recently developed depot - estrogen (ethinylestradiolsulfonate). While the untreated women showed typical serum FSH-and LH-patterns characteristic of the biphasic menstrual cycle, patients on combined therapy were found to have a continuous low FSH- and LH-level except in the postmenstrual phase of the cycle, in which the values were slightly elevated. Serum-FSH-concentration in the woman on the sequential preparation remained constant throughout the treatment peroid, while serum LH-pattern showed multiple peaks. In the same manner, serum LH-patterns in women on the weekly depot- estrogen regimen were characterized by nearly regularly appearing LH-peaks, which seemed to be correlated with the estrogen intake. The cause and clinical significance of these findings are discussed.

Contraceptives, Oral↗
PubMed1987

The relationship between retrospective premenstrual symptom reporting and present oral contraceptive use.

The premenstrual assessment form (PAF) was used to assess the degree and type of premenstrual changes reported by 101 oral contraceptive users and 149 non-users (aged 18-45 yr) attending general health and gynaecology clinics. Women using oral contraceptives did not complain of fewer or less severe symptoms overall, but their severity scores on the subscales of premenstrual anxiety, fatigue, low mood, water retention, and impaired social functioning were significantly lower than those of non-users. The duration of oral contraceptive use and the type of preparation (combined or phased) taken were not related to the degree of premenstrual change reported. Complaints of symptoms beginning more than two days before menstruation were less frequently reported by pill-users (p less than 0.01) and were associated with a greater severity of all types of premenstrual change (p less than 0.0001). Women who had experienced difficulties tolerating oral contraceptives reported a greater number of moderate/severe premenstrual changes (p less than 0.0001).

Adolescent↗