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The secretion of human chorionic gonadotropin-like substance in women employing contraceptive measures.

To study the secretion pattern of a hCG-like substance (hCG') in normal women and those employing contraceptive measures, we assayed daily urine concentrates by RIAs using an anti-hCG beta-COOH-peptide serum and an anti-hCG serum to monitor hCG' and human LH (hLH), respectively. In eight cycles of four normal women, urinary hCG' was within the normal range (less than 100 ng/day), except that four samples in two women had marginal elevations of hCG' during the menstrual or premenstrual period, but not at the time of the midcycle hLH surge. Among seven cycles from three intrauterine device (IUD) users, six showed midcycle hLH surges, and in five, hCG' was prominent (0.17-3.6 micrograms/day) in the late luteal phase. In eight cycles of women ingesting steroid contraceptives on a conventional schedule, hCG' was found during the premenstrual and menstrual intervals. The pattern of hCG' secretion was episodic, and hCG' levels were in the range of 0.3-1.8 microgram/day. It was notable that hCG' was excreted at the highest levels during intervals when ingestion of steroids was withheld. These findings suggest that contraceptive steroid hormones may modulate pituitary hCG' secretion. From gel high pressure liquid chromatographic studies, the immunoactive hCG' detected in urinary extracts from normally cycling women and IUD users had a molecular size larger than hCG beta and hLH, but was slightly smaller than hCG (lot CR119). The hCG' identified in these eluents is unlikely to be a subunit of hCG. On the other hand, the immunoactive hCG' in the urinary extracts from oral contraceptive users was mainly the hCG beta-subunit-like substance. Both hCG alpha and hCG beta immunoactive substances were heterogeneous in size in contrast to those found in normally cycling women and IUD users. In summary, the hCG' excretion pattern was different in menstrual and postmenopausal women, and hCG' identified in these subjects was heterogeneous.

Adult↗

Iron status in Danish women aged 35-65 years. Relation to menstruation and method of contraception.

Iron status was assessed by serum (S-) ferritin and hemoglobin (Hb) in a population survey comprising 883 non-gravid Danish women in age cohorts of 35, 45, 55, and 65 years. Premenopausal women (n = 676) had lower S-ferritin, median 42 micrograms/l, than postmenopausal women (n = 207), median 80 micrograms/l (p < 0.0001). Of premenopausal women, 12.1% had S-ferritin < or = 20 micrograms/l (i.e. depleted iron stores), and 35.6% S-ferritin of 21-40 micrograms/l (i.e. small iron stores). Corresponding figures in postmenopausal women were 0.5% and 13.2%. Premenopausal blood donors (n = 88) had lower S-ferritin than non-donors (p < 0.001). In premenopausal women, S-ferritin levels were strongly dependent on the duration of menstrual bleeding (p < 0.0001), which in turn was related to the method of contraception. Women (n = 64) using hormonal contraceptives (the pill) had menstrual bleeding of shorter duration than those (n = 511) not using pills or intrauterine devices (IUD), who in turn had bleeding of shorter duration than those (n = 101) using IUD. Median S-ferritin in pill users was 62 micrograms/l, in those not using pills or IUD 42 micrograms/l, and in IUD users 36 micrograms/l. S-ferritin values < 40 micrograms/l (i.e. small and depleted iron stores) were seen in 25% of pill users, in 48% of those not using pills or IUD, and in 61% of IUD users.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Self-esteem, spiritual well-being, and intimacy: a comparison among couples using NFP and oral contraceptives.

The purpose of this study was to compare the intimacy, spiritual well being (SWB), and self-esteem of couples using natural family planning (NFP) with those couples using oral contraceptives (OCs). 22 couples who were using the Creighton Model Ovulation Method of NFP for 1 year to avoid pregnancy were matched with 22 couples who were using OCs for a least a 1-year period and administered a SWB, self-esteem, and intimacy inventory. Student t-tests were calculated to determine differences in the mean scores of the 3 inventories between the 2 groups. The results showed that the NFP couples had statistically higher self-esteem (T=3.15, p0.01), SWB (T=4.25. p0.001), and intellectual intimacy (T=2.53, p0.05) than the OC couples. There were no differences in emotional, social, recreational, and sexual intimacy between the groups. Although the results provide some evidence that NFP can enhance a couple's relationship, other factors such as a sampling bias and educational levels could explain the difference.

Americas↗

Desogestrel-ethinylestradiol, an oral monophasic contraceptive. Clinical and lipid metabolic effects: a 5-year experience.

A comparative study of 5 years' duration using desogestrel (DSG), levonorgestrel (LN), and norethindrone (NET), combined with ethinyl estradiol (EE), was conducted. A total of 4499 cycles on DSG-EE, 3691 on LN-EE (1980 on triphasic and 1711 on monophasic schemes) and 1680 on NET-EE was evaluated. A contraceptive efficacy of 100% was obtained in all the groups. Minimal side effects were observed. In particular, body weight in those women on DSG-EE did not show noticeable changes and headaches were minimal. No alterations on blood pressure readings or on the routine laboratory tests were noticed in any of the groups. There was a significant increase in high-density lipoprotein-c (HDL-c) in women on DSG-EE. There was no change in NET-EE, and a significant decrease in women on LN-EE in both schemes. Changes in LDL-C, very low density lipoproteins, triglycerides, total lipids, total cholesterol, and glucose were not significant, although there was some increase at 60 cycles on triglycerides on those women on DSG-EE and on NET-EE. At the end of 5 years, 76% of women continued on DSG-EE. They indicated their satisfaction with this method.

Americas↗

Clinical experience with the recently developed progestogens.

The third generation of combination estrogen/progestogen oral contraceptives (OCs) first became available in the early 1980s. The gonanes (e.g., norgestimate, desogestrel, and gestodene) are alternatives to the long-standing progestogens, norethindrone and norgestrel/levonorgestrel. While the newer compounds are related to levonorgestrel, their biochemical structure differs. All, however, are strongly progestogenic with respect to ovulation inhibition and are very selective in their affinity for endometrial progesterone receptors. At present, experience with the third-generation combined OCs is relatively limited, and extensive comparative data have yet to be accrued. Nevertheless, these ultra-low-dose compounds appear to be as efficacious as the traditional OCs, while their cycle control may be slightly superior. In addition, the incidence of minor side effects, such as nausea, weight gain, and mastalgia, compares favorably with that of the earlier OCs. In combination with estrogen, these new progestogens have revealed a neutral or possibly beneficial effect on lipid/lipoprotein metabolism. Thus, the newer progestogens do not appear to have adverse effects on the cardiovascular system and offer a range of noncontraceptive health benefits.

Contraceptives, Oral, Combined↗

Trends in the contraceptive practices of women seeking abortions in the 1980s.

The demographic features and contraceptive practices of 1000 women attending Parkview clinic of Wellington Hospital for termination of pregnancy were studied over an eight month period in 1988-9. Comparisons were made with a previous study at the same clinic in 1980-1. The overall abortion rate has increased from 6.8/1000 women in the Wellington statistical area in 1981 to 9.8 in 1989. The proportion of Pacific Island and Asian women presenting for abortions is high and has increased disproportionately between 1981 and 1989. The abortion rate has also increased in lower socioeconomic groups in 1989. The proportion of women using contraception at the time of conception increased from 50% in 1981 to 68.5% in 1989. The methods used by women presenting for abortion have changed significantly. There has been an increase in the proportion of women using condoms (from 13.3% to 36.2%) and the oral contraceptive pill from (14% to 21.4%).

Abortion Applicants↗

Trends in use of oral contraceptives--data from the 1987 National Health Interview Survey.

Despite fluctuations in current use rates for oral contraceptives, ever-use of the pill has remained remarkably stable for all cohorts of U.S. women born since 1945. Approximately 80 percent of these women report having used the pill at some time. Average duration of use is about five years among cohorts who had access to the pill from their earliest reproductive years. Among women born before 1940, whites are more likely than blacks to have ever used the pill, but no racial difference is evident among women in later cohorts. Age at first use of the pill has declined with each succeeding five-year birth cohort. Black women are more likely than white women to have used oral contraceptives before age 18, but by age 25, about three-fourths of blacks and whites have used the pill. Among ever-users born before 1945, the majority began taking the pill after their first full-term pregnancy; this pattern is reversed among more recent cohorts.

Adolescent↗

Oral contraception with a triphasic combination of gestodene and ethinyl estradiol: results of a multicenter clinical study.

The clinical effects of a low-dose triphasic oral contraceptive containing the new progestogen gestodene and ethinyl estradiol were investigated in phase II and III multicenter studies. The phase II study compared the clinical effects in 377 women taking this new compound during 2123 cycles with the effects of a low-dose triphasic combination of levonorgestrel and ethinyl estradiol in 362 women treated in 2088 cycles. The discontinuation rates after 6 months were similar in the two groups, and no major differences in side effects were observed. Cycle control was better during intake of the gestodene-containing preparation, since spotting occurred less frequently (P less than .05). The phase III investigation comprised 1921 women representing a total of 27,308 cycles. The Pearl index was 0.05. During the 24-month trial, 243 women (12.7%) dropped out of the study because of side effects, mainly bleeding disturbances (6.0%), headache (2.2%), and breast tension (2.0%). The results of these studies indicate that the triphasic combination of gestodene and ethinyl estradiol is well tolerated and provides high contraceptive efficacy and good cycle control.

Clinical Trials as Topic↗

Contraceptive practice in New Zealand.

A survey of contraceptive practice in New Zealand was carried out using a population-based sample of women, aged 25 to 54, selected as control subjects in a national case-control study. The results showed that sterilisation has become the most common means of family limitation. Overall, 45% of women aged 25 to 54 were in a union where one or the other partner had been sterilised. Vasectomy was the most common method of contraceptive sterilisation. The frequency of hysterectomy contributed to the high rates of sterilisation; 12% of women had had a hysterectomy. Over 80% of New Zealand women had used an oral contraceptive at some time, but only 11% were using the pill at the time of the survey. Comparison with earlier studies of contraceptive use in New Zealand show there has been a marked increase in the prevalence of contraceptive sterilisation, and a marked decrease in the use of oral contraceptives.

Acquired Immunodeficiency Syndrome↗

Contraception.

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Cervix Mucus↗