[Bleeding hepatic adenoma and its relation to oral contraceptives].
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20 fertile women who were treated with mestranol as oestrogen and both gestagenes chlormadinonacetate and norethisteronacetate were investigated. Alkaline phosphatase, ASAT, ALAT, alpha-amylase, cholesterol, bilirubin, serumproteins, indocyanine green half time, paper electrophoresis of serumproteins, thymol and zinc sulfate turbidity tests were examined during the first therapy cycle. Elevation of ALAT activity (6,3 I U/l to 12,14 u/l) was found during treatment with mestranol/chlormadinonacetate. A depression of ALAT (up to 5,34 u/l) was observed under additional therapy with gestagene chlormadinonacetate. Statistical significance was noted only for ALAT and alpha 1 globuline under sequential therapy with mestranol/norethisteronacetate.
Platelets from healthy females, who were taking oral contraceptives over a long period of time, were investigated by ultrastructural morphometry. The size, shape, relative volumes, numerical and surface densities of the platelets and their organelles were measured. In 'long-term pill users' the platelets showed a significant increase in the area of section profile. Further changes as, for example, increased volume of platelet granules, reduced number of mitochondria, decreased volume and surface of the open canalicular system, and increased surface of the dense tubular system are to be noted.
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The multiple physiologie stages of method by oral hormonal anticonception was reported, which have been in use in combination. Since 1969 about 362 women at the average age of 27,5 years received 10281 cycles, that means in an average cycles from 28,4 days, the stage method from 11/10 days or 7-7-7 days rhythmus.
A total of 14,856 women, including 921 pregnant subjects, were tested for rheumatoid factor; 4,562 were using oral contraceptives at the time of testing. The prevalence of rheumatoid factor increased directly with age. The age-adjusted prevalence of rheumatoid factor was lower in oral contraceptive users than in nonusers but this difference was not statistically significant. Rheumatoid factor remained positive in 39% of subjects undergoing retesting after an average interval of 16 months. Those women with higher titers of rheumatoid factor were more likely to remain positive (81%). Of the women having positive tests, 5.4% were identified as having rheumatoid disease.
19 women with anovulation after discontinuing oral contraceptive agents and with normal plasma-prolactin concentrations were treated with bromocriptine. Ovulation and menstruation were restored in 9 of the 13 amenorrhoeic and 5 of the 6 oligomenorrhoeic patients. The success-rate (74%) indicates that bromocriptine is an effective treatment for post-pill anovulation in normoprolactinaemic women.
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Problems associated with the use of the Beagle dog in chronic toxicological studies of contraceptive steroids are described. A short review is presented on the occurrence of spontaneous tumours in dogs and in bitches of various breeds. The current status of knowledge of canine reproductive hormones and endocrinology is outlined, together with effects of contraceptive steroids. The pathology and histological classification of spontaneous and induced mammary neoplasia in the dog is discussed and compared with breast cancer in women. A series of recommendations are included for future research in this field which it is hoped may resolve some of the outstanding issues and lead to a more suitable toxicological model for contraceptive steroids.
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The effect of trans-4-amino-methyl-cyclohexane acid (AMCA) and a placebo preparation on the development of alveolitis sicca dolorosa (ASD) was investigated in a double-blind designed experiment. The preoperative registrations were age, sex, use of oral contraceptives, menstrual cycle, smoking, degree of impaction and operation time. The study included 120 healthy persons. Each person had bilateral impacted mandibular molars removed surgically at one session. AMCA (160 mg/extraction site) or placebor was applied in each socket after the operation. The postoperative course was evaluated on average 5 days later by the use of 13 different variables describing local and general discomfort. The incidence of ASD was 7.5% in the AMCA side and 5.0% in the placebo side. The result shows that a local inhibition of plasminogen activation by AMCA is insufficient to prevent the development of ASD. The occurrence of ASD and postoperative discomfort was not increased in women operated during the menstrual period. The usage of oral contraceptives is known to be associated with a high frequency of ASD. Women taking oral contraceptives may therefore postpone the operation to the withdrawal period of the pill, to reduce the risk of developing ASD. Postoperative pains and the consumption of analgetics were significantly increased in patients who were habitual smokers.
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A longitudinal study in 60 women was undertaken to observe the changes, if any, in serum bile acids after taking oral combination pills containing either 50 or 30 microgram of ethinyl estradiol. The women were followed up to 12 months. Serum bile acids (cholyglycine conjugates) were estimated by radioimmunoassay. The combination contraceptives had no appreciable effect on serum bile acids.
A clinical investigation of 356 patients with secondary amenorrhea revealed that 95% of patients with postpill amenorrhea and 56% of patients with anorexia nervosa recovered in 6 years. The corresponding recovery rates for patients with psychogenic amenorrhea and amenorrhea following self-induced weight loss were 72% for both groups, and in patients with the amenorrhea-galactorrhea syndrome and idiophatic functional amenorrhea the recovery rates at 6 years were 64 and 61% respectively. Unlike the other groups with functional amenorrhea, patients with the amenorrhea-galactorrhea syndrome had impaired ovarian responsiveness to exogenous gonadotropins. Bromocriptine treatment resulted in disappearance of the galactorrhea and restoration of the menses and/or ovulation in nine of 18 patients; of these three became pregnant. The effect of bromocriptine did not persist for long after treatment ceased, and permanent recovery was recorded only in four patients. The group with functional amenorrhea included 34 patients who wished to become pregnant. Gonadotropin treatment was successful in 20 patients, clomiphene-hCG in two, tamoxifen in two, bromocriptine in two, and combined bromocriptine and clomiphene in one. Thus, the overall pregnancy rate in patients with functional amenorrhea was 79%. The groups with ovarian amenorrhea inclutients with assumed ovarian failure responded to large doses of exogenous gonadotropins by ovulation and three became pregnant. Ovarian wedge resection was ineffective in all five cases with polycystic ovaries, but two patients became pregnant after treatment with clomiphene and chorionic gonadotropin, and one with exogenous gonadotropins.
Gestamimetic amounts of progesterone enhance basal and glucose-stimulated insulin production. Contraceptive doses of synthetic progestins cause a moderate increase or no change in glucose-stimulated insulin production, depending on route of administration and species tested. Estrogens potentiate the insulinotropic effects of progesterone and the synthetic progestins. Basal serum triglyceride concentrations are generally unaffected by progesterone or 17 alpha-acetoxyprogesterone treatment but may decrease during 19-nortestosterone administration. Glucose tolerance does not change during treatment with gestamimetic doses of progesterone alone but may improve in rats and monkeys during concurrent estrogen administration. By contrast, deterioration of glucose tolerance is observed in women treated concurrently with synthetic estrogen plus 19-nortestosterone derivatives and, occasionally, with 19-nortestosterone derivatives alone. No consistent changes in glucose metabolism have been observed after treatment with 17 alpha-acetoxyprogesterone derivatives alone. The cause of the species-related differences in glucose metabolism during 19-nortestosterone treatment is obscure.
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