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Glucose and insulin levels after six months of treatment with a triphasic oral contraceptive containing ethinyl estradiol and norethindrone.

A prospective study of carbohydrate metabolism was done on 33 women who used a triphasic oral contraceptive (OC) containing ethinyl estradiol and norethindrone for six months. A three-hour oral glucose tolerance test was administered before and after the OC usage, and both the blood glucose and insulin levels were determined. A significant decrease in the fasting glucose level was found with treatment. All other glucose values and insulin levels were unchanged.

Adult↗

Adult attachment and long-term effects in survivors of incest.

OBJECTIVE: The aim of the study was to test the hypothesis that adult attachment is related to distress and personality disorders in incest survivors. METHOD: Adult female incest survivors recruited from the community participated in a structured interview (Family Attachment Interview; Bartholomew & Horowitz, 1991) and completed measures of current functioning (Impact of Event Scale, SCL-10, Beck Depression Inventory) and personality (MCMI-II). Complete data from 92 cases out of the total sample of 112 were analyzed. RESULTS: Analyses of variance suggested that attachment (as represented by a category) was significantly related to personality structure, with fearful individuals showing more avoidant, self-defeating, and borderline tendencies and preoccupied individuals showing more dependent, self-defeating, and borderline tendencies than secure or dismissing individuals. Results of hierarchical regression analyses suggested that attachment (as represented by four dimensions) was significantly associated with personality structure, depression and distress, and abuse severity with post traumatic stress disorder (PTSD) symptoms (intrusive thoughts and avoidance of memories) and depression. CONCLUSIONS: The findings demonstrated the propensity for insecure attachment among incest survivors. Sexual abuse severity and attachment have significant but distinct effects on longterm outcome; abuse characteristics predict classic PTSD symptoms and attachment insecurity predicts distress, depression, and personality disorders above and beyond any effects of abuse severity.

Adult↗

Post-marketing surveillance of oral contraceptives.

Problems arise in the post-market surveillance of the possible long-term effects of oral contraceptives. These drugs are taken by very large numbers of people, in various doses, types and duration. One aspect is considered in this paper, the effects on pregnancy of these drugs taken before conception. Retrospective case trial studies are described together with longitudinal studies on women from their first exposure to a specific oral contraceptive. The difficulties of this approach, the causes of bias, the effect of social habits, and the discontinuity of usage are debated.

Contraceptives, Oral↗

A bacterial mutagenicity study of rivanol, an acridine derivative used as an abortifacient.

We have used the forward mutation to resistance to 6 azauracil to test the mutagenicity of rivanol (6,9 diamino 2-ethoxy acridine) on Escherichia coli. Rivanol has been used to induce therapeutic abortions in midpregnancy and is considered safe and effective for this purpose. The findings reported here that rivanol, like other acridines, is a mutagen, at least in procaryotes, suggests that such use of rivanol be reconsidered in light of its possible genetic toxicity.

Abortifacient Agents↗

[Prospective studies on pregnancy following induced and spontaneous abortion of primigravidae and assessment of fertility. IV. report].

Prospects for imminent and spontaneous abortion were studied in three groups of probands. These included secundigravidae following induced abortion, secundigravidae after spontaneous abortion, and primigravidae. --Chronological distribution of abortion was determined for two periods of time, up to the 16th week of pregnancy and between the 17th and 27th weeks of pregnancy. Reference is made to correlations between abortion and cervical insufficiency. Poor prognosis in a group with a record of spontaneous abortions was compared with accumulation of functional bleeding in the same group. --An account is given also of the incidence of defective infants in all three groups, in the context of prematurity.

Abortion, Induced↗

Observations on the effects of alpha-chlorhydrin on the testes and pituitary gonadotrophs of gerbil (Meriones hurrianae) and rat.

(1) Lower doses of alpha-chlorhydrin caused high selectivity of lesions in the seminiferous tubule of rat and gerbil. (2) The seminiferous epithelium became systematically depleted of spermatogonia, spermatocytes, spermatids and finally spermatozoa in this sequence. (3) The suppression of RNA concentration in the testes and seminal vesicle is conspicuous. (4) The growth of androgen-dependent organs, i.e. seminal vesicles, ventral prostate, epididymes and perineal complex, is suppressed. (5) These effects are reversible. Repopulation of testis tubules occurs followed by a 40-day recovery period in rat and gerbil. (6) alpha-Chlorhydrin administration brings about hypertrophy of pituitary gonadotrophs which is also reflected in the increased basophilic cell percentage (control: 15.5% alpha-chlorhydrin: 21.5%; p less than 0.01).

Animals↗

Effects of long-term estrogen replacement therapy. I. Metabolic effects.

Two groups of hypoestrogenic women are analyzed by retrospective comparisons. Patients were observed by a single group of physicians for at least five years; 301 patients were treated with replacement estrogen and 309 patients were untreated. Incidence figures for various metabolic diseases present at entry and both during and after estrogen therapy were compared by the usual statistical analysis and by statistical adjustments for certain group differences (Mantel-Haenszel statistic). The long-term administration of estrogen to these relatively young women with hypoestrogenism was associated with significantly lower rates of development of cardiovascular disease, hypertension, osteoporosis, and fractures. Detrimental effects were a higher rate of abnormal uterine bleeding and an increase in the likelihood of developing adenocarcinoma of the endometrium. Effects of estrogen preparation, dosage, method of therapy, duration of therapy, and the addition of synthetic progestins are presented.

Adenocarcinoma↗

Long-term follow-up of children whose mothers used oral contraceptives prior to conception.

Anthropometric, psychometric and hematologic measurements were made at intervals in the first 3 years of life in a cohort of 732 infants, including 177 (24.2%) whose mothers used oral contraceptives (OC) prior to conception. Analysis of the data focused on weight and height measurements at 3, 9, 12, 24 and 36 months of age; hemoglobin and hematocrit at 9 months; development quotient (DQ) at 2 years and its components, posture, coordination, language and social; and intelligence quotient (IQ) at 3 years and its verbal and nonverbal components. Analyses were made for both sexes combined and males and females separately, by examining crude means, and means adjusted through linear multiple regression for birthweight, age of child at the time of examination, height of mother, mother's weight-for-height centile, birth-order, maternal and paternal education, and maternal smoking. No significant differences were found between the children whose mothers did or did not use oral contraceptives.

Adult↗

Evidence of chlamydial infection in infertile women with and without fallopian tube obstruction.

This study investigates the prevalence of Chlamydia trachomatis antibodies in 164 infertile women who underwent diagnostic laparoscopy and dye insufflation as part of routine infertility investigations. C. trachomatis antibodies were found in 36 (22%) of 164 infertile women, which was significantly more than the prevalence of antibodies in a control group (22 of 200, 11%). C. trachomatis antibodies were found in 25 (35.7%) of 70 infertile women who had laparoscopically verified peripheral tubal disease. This was significantly more than the prevalence of C. trachomatis antibodies in infertile women with normal fallopian tubes (6 of 52, 11.5%). The prevalence of C. trachomatis antibodies in infertile patients with laparoscopically verified cornual disease was similar to those without cornual disease. C. trachomatis was not isolated from any of the patients studied. This study confirms that past chlamydial salpingitis is associated with the development of peripheral fallopian tube obstruction with resultant infertility.

Adult↗

Breast cancer before age 45 and oral contraceptive use: new findings.

The relation between the risk of breast cancer before 45 years of age and oral contraceptive use was examined in a case-control study conducted in New York, Philadelphia, Baltimore, and Boston from 1983 to 1986 of 407 patients with breast cancer and 424 controls. With allowance for confounding, for ever use, the multivariate relative risk estimate was 2.0 (95% confidence interval (CI), 1.4-2.9). For less than 10 years of use, the estimate approximated 2.0 in all categories of duration, including less than three months; for 10 or more years of use it was 4.1 (95% CI, 1.8-9.3). The association was apparent in virtually all subgroups examined, including younger and older women, and women at low and high underlying risk of breast cancer. Contrary to some previous reports, the association was not stronger for use before a first term pregnancy or at an early age. The results suggest that oral contraceptive users, particularly those with very long durations of use, may be at increased risk of breast cancer. However, information bias, particularly for short-term use, could not be ruled out. There may also have been selection bias if oral contraceptive users were under more intensive medical surveillance. It has not been possible to reconcile the findings of the various studies to date, including the authors' earlier results showing no association. The latter results were derived from data collected using methods almost identical to those used in the present study.

Adult↗

The psychological complications of therapeutic abortion.

Psychological or psychiatric disturbances occur in association with therapeutic abortions but they seem to be marked, severe, or persistent in only a minority (approximately 10%) of women. These consist mostly of caseness depression and anxiety. Psychoses are very uncommon, being reported in only 0.003% of cases - most of whom have a history of previous psychiatric illness. Certain groups are especially at risk from adverse psychological sequelae; these include those with a past psychiatric history, younger women, those with poor social support, the multiparous, and those belonging to sociocultural groups antagonistic to abortion. This is not to overlook the fact that, adopting a crisis-resolution framework, subsequent termination of an unwanted pregnancy is itself 'therapeutic'. A better understanding of the nature of the risk factors would enable clinicians to identify vulnerable women for whom some form of psychological intervention might be beneficial.

Abortion, Therapeutic↗