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Biomedical subjects

J Drife

Publications and source records attributed to J Drife.

14 recordsLinked to original sources
PubMed1990

Benefits and risks of oral contraceptives.

Like all drugs, combined oral contraceptives (COCs) have side effects that may be harmful or beneficial. During the last 20 years their adverse effects have been fully reported, but their benefits have been largely ignored. Most of the benefits of COCs result from the suppression of ovulation. This means that the advantages they confer are not dose-dependent, provided that ovarian activity is effectively suppressed. The most important health benefit of COCs worldwide is the effective prevention of pregnancy, which carries high risks in developing countries and has a mortality as high as 1 in 150 in Africa. The risk of ectopic pregnancy is reduced by 90% in COC-users compared with women using no contraception. The COC prevents the repeated proliferation of ovarian and endometrial tissue that takes place in the menstrual cycle, and it is therefore not surprising that it reduces the risk of ovarian and endometrial malignancy. What is surprising is that a relative risk of 0.6 for these cancers can be detected after only 12 months or less of COC use, and persists for at least 15 years after the COC is stopped. The COC reduces the incidence of benign breast disease, though not the types of disease linked with breast cancer. It considerably reduces the incidence of benign ovarian cysts, and this has been calculated to avoid 28 operations for functional ovarian cysts per 100,000 pill users every year. The risk of uterine fibroids is reduced by 17% with every five years of COC use. By thickening the cervical mucus, the COC reduces the risk of pelvic inflammatory disease by about 50%. By inhibiting growth and development of the endometrium it reduces the incidence of menorrhagia and consequently iron-deficiency anaemia, and it produces a 40% reduction in the frequency of dysmenorrhoea. Unlike the benefits of the COC, its risks appear to be to some extent dose-dependent. The first serious risk to be discovered was a three- to six-fold increase in venous thromboembolism, which is probably an oestrogen effect and disappears quickly when the COC is stopped. The COC doubles the risk of haemorrhagic stroke, this risk is related to smoking and hypertension, unlike the increased risk of thrombotic stroke. The risk of myocardial infarction is related to smoking and age, and COCs are contraindicated over the age of 35 in smokers though not necessarily in non-smokers. Much of this information, however, is based on studies involving older high-dose COCs. Risks may well be lower with modern COCs, but firm data are lacking.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1986

Hormonal contraception and cancer.

The natural menstrual cycle can influence the development of some cancers. Combined oral contraceptives, which replace normal hormonal fluctuations with steadier levels of artificial sex hormones, appear to protect against cancers of the endometrium and ovary, but their effect on carcinomas of the breast and cervix remains uncertain.

Breast Neoplasms↗
PubMed1983

Which pill?

Explore the source record for details and available documents.

Adult↗
PubMed1976

Plasma estrogen response to dehydroepiandrosterone sulphate injection in normal and complicated late pregnancy.

Dehydroepiandrosterone sulphate (DHAS) was administered intravenously to 70 women in the third trimester of pregnancy. By measuring the increase in the concentrations of estrogens in maternal plasma, it was hoped to assess the reserve capacity of the placenta. In normal pregnancies, unconjugated estradiol invariably showed a marked increase within 60 minutes of the injection of DHAS, reaching 174 to 478% above basal levels. Changes in unconjugated estrone were more variable, but significant increases usually occurred 2 to 3 hours after the peak concentration of estradiol. The concentrations of unconjugated estriol showed no significant change. Patients with preeclampsia, essential hypertension, retarded intrauterine growth, diabetes, and twin pregnancies did not show any major differences in response compared to the normal pregnancies. Two patients with intrauterine deaths had low basal concentrations of estrogens but responded to the DHAS injection by having significantly increased concentrations of unconjugated estradiol after 60 minutes. The only patient who did not show any increase in unconjugated estradiol levels after DHAS was thought to have a placental sulphatase deficiency. This test does not appear to have any advantage over existing methods of assessing the endocrine function of the placenta except in confirmation of placental sulphatase deficiency.

Dehydroepiandrosterone↗