Treatment of postpartum rhesus monkeys with progestogen: appearance in milk and effects on lactation.
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Forty-four women were prospectively evaluated with a 3-hour oral glucose tolerance test while they used a new weekly oral contraceptive drug, R2323. The blood tests were carried out before the drug was administered and again 3 months after its use. Both blood glucose and plasma insulin levels were measured. In the 40 women with a "normal" control glucose tolerance test, it was found that only the 1-hour blood glucose value was significantly elevated after 3 months of drug use and the plasma insulin values were unchanged. The tests of three of the four women with borderline abnormal to abnormal control test curves converted to normal with 3 months of treatment and that of one remained unchanged. The fasting plasma cholesterol and triglyceride levels were unchanged over the 3 months' time. These results suggest that this steroid contraceptive has no effect on lipid metabolism. It also has minimal adverse effects on normal carbohydrate metabolism and may possibly improve abnormal metabolism.
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OBJECTIVE: Although frequently pointed out in the aetiology of chronic angioedema or chronic abdominal pain, food allergy is frequently a diagnosis for lack of anything better, as exemplified by disappointing results of eviction regimens. This has resulted in the search for other aetiologies, such as an iatrogenic effect of oral contraceptives. METHODS: Detailed medical history was obtained on 38 young women, aged a mean of 26 years, experiencing chronic angioedema initially ascribed to food hypersensitivity, but in whom a deficit in C1 inhibitor was demonstrated. We investigated the effects of oral contraception on their level of C1-INH, functional C1-INH assay and their clinical symptoms. RESULTS: An interruption of oral contraception induced an increase of the C1-INH level from 0.201 to 0.224 g/L (p < 0.002) and of the C1-INH functional assay fom 0.396 to 0.702 U (p < 0.0001), associated with a recovery or a marked improvement of the clinical symptoms formerly ascribed to food allergy. The replacement of the initial contraception containing ethinyloestradiol by a progestogen maintained or even improved their clinical and biological state. CONCLUSION: Exogenous estrogen such as those contained in most oral contraceptive may play an iatrogenic role in the aetiology of chronic angioedema.
The hereditary angioneurotic oedema is an exceptional disease of deadly risk from glottic oedema. The diagnosis is based on a very low serum C4, with collapsed C1 INH for a patient who has repeated attacks of Quincke's oedema or pseudo occlusive digestive crisis. These crisis are prevented by taking anabolic steroids and must be treated when they are serious by intravenous C1 INH. The recent contributions of the immunogenetic and the interest of a national registry are underlined.
A new case report of primary malignant hepatic tumor during a long term oral contraception is presented. A direct role of contraceptives drugs cannot be claimed because of little cases reported. Nevertheless, appearance of carcinogenic compounds in predisposed women may be evoked.
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NORPLANTTM (Laboratorios Gutfol, S.A., Mexico City, Mexico) subdermal implants containing levonorgestrel were accepted by 816 women in a two-phase study initiated in 1975 and augmented in 1978. Through 3 years of first-segment use, acceptors experienced five pregnancies, a cumulative net rate of 0.7 per 100, and a gross pregnancy rate of 1.1 per 100. First-segment continuation at 3 years was at the rate of 44.6 per 100, an annual average of 76 per 100. NORPLANT users experienced irregular menstruation, with high interindividual variation, but with normal average numbers of bleeding days and of bleeding episodes. Hemoglobin levels increased moderately during implant use. The incidence of systolic blood pressure readings above 145 mm Hg or diastolic readings above 95 mm Hg was similar to that observed among users of the TCu 200 intrauterine device enrolled under the same selection criteria in the same clinics between the two phases of the NORPLANT study. Comparative data on pregnancy and other rates are also given for these intrauterine device acceptors.
TwO cases of megaloblastic anaemia, of which one was very severe, occurring in women who had been taking oestrogen-progestogen oral contraception over a long period of time, are reported. The authors take the opportunity, after having reviewed the literature, of pointing out the role of oestro-progestogen products in bringing about vitamin deficiencies. They discuss how and where oestrogen-progestogen products work on folic metabolism and emphasize that there is an associated factor which starts off the deficiencies.
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