[STUDIES ON THE BIOSYNTHESIS OF STEROID HORMONES].
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A combined oral contraceptive consisting of ethinyl estradiol (EE2) in three dosages (50, 100, and 400 micrograms) and norethindrone (0.5 mg) was given to female chimpanzees to determine the effect on endogenous sex hormone levels and anogenital swelling. Serum levels of EE2 increased with increasing dosages of EE2, estradiol decreased, and luteinizing hormone, progesterone and testosterone were maintained at approximately midfollicular phase levels. Urinary levels of EE2 glucuronide increased with the increasing dosages of EE2, whereas estrone and pregnanediol glucuronide were essentially undetectable. The cyclic increase in female anogenital swelling was abolished when the norethindrone was combined with 50 micrograms of EE2 and relatively constant and low levels of swelling were recorded. Relatively constant but successively higher levels of swelling were recorded when the norethindrone was combined with the higher dosages of EE2. These effects of oral contraceptives on female genital tissues are relevant to our laboratory studies of sexual behavior in chimpanzees given oral contraceptives and could also have implications for women taking oral contraceptives.
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The cellular and molecular mechanism of RU486, a steroid hormone antagonist, is discussed in detail. Principally, RU486 opposes the action of two types of hormones: progesterone and glucocorticosteroids. The clinical applications are also described, as well as the future outlook.
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The first of a second generation of slow-release injectable contraceptives is the norethindrone (NET) microspheres with a 90-day duration of action. It was evaluated at 65-mg and 100-mg doses for safety and contraceptive effectiveness in two randomized, single-blind trials among 131 women: 94 women for 12 months and 37 women for 6 months. The 6-month trial included additional evaluations of ovarian function and serum NET values. In the 6-month trial, no indication of ovulation was detected in the 100-mg dose group, while 3 of the 19 women in the 65-mg group showed signs of ovulation (progesterone greater than 3 ng/ml). No pregnancies were reported in the 100-mg group and one pregnancy in the 65-mg group resulted in a life-table pregnancy rate for that dose of 2.6 per 100 woman-years (95% confidence interval, 0 to 7.5). Days of vaginal bleeding were analyzed for 30 days before treatment and in 90-day reference periods after treatment. The mean number of vaginal bleeding and spotting days increased initially after the first injection in both dose groups, but decreased to below baseline in both dose groups after 6 months. The two doses appear comparable in clinical safety, side effects, vaginal bleeding patterns, and laboratory measures. With the preliminary estimate of efficacy, the 65-mg dose would be the minimally effective dose for the NET 90-day injectable contraceptive.
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The present study examined the effects of exogenous and endogenous ovarian hormones on auditory functioning in young women. Fluctuations in pure tone thresholds and temporary threshold shifts (TTS) at 4 kHz and 6 kHz were assessed across the menstrual cycle. A group of normally cycling, ovulatory women and a group of women using Ortho Novum 7/7/7, a tri-phasic oral contraceptive, were tested during menstruation, at ovulation, and during the luteal phase of their menstrual cycle. A group of men served as controls and were tested at 3 similarly spaced intervals. Only the normally cycling women had significant cyclic fluctuations in auditory sensitivity, displaying poorer thresholds at 4 kHz during the menstrual phase than at the time of ovulation or during the luteal phase. In addition, normally cycling women were found to have significantly less TTS at 6 kHz during the menstrual phase than women using oral contraceptives.
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