Glycemic status in women using combined oral contraceptive pill

This study was undertaken to determine the effects of low-dose combined oral contraceptives(OCs) containing 30 gm Ethinyl estradiol with 150 microg Levonorgestrel on carbohydrate metabolism by a glycaemic variable -- fasting blood glucose level. It is now known that impairment of carbohydrate metabolism is a potential risk factor for cardiovascular disease and other metabolic disorder. Sixty women age between 15-35 years using OCs served as experimental group and thirty age matched hormonal contraceptive non users were selected for control group. Experimental group was again subdivided into OCP (Oral contraceptive pill) users for last one year group, three year group and five year group. The result showed that there were no significant differences on blood glucose level between users and non-users women. It is concluded that the cyclic administration of monophasic low dose OCs did not altered blood glucose levels and there by have no additional adverse impact on women health reaffirming the ongoing oral contraceptive pill distribution program.     

Serum alkaline phosphatase and bone mineral density: to assess bone loss in oral contraceptive pill user

An analytic cross-sectional retrospective study was done in the Department of Pharmacology BSMMU. In collaboration with the Department of Obstetric and Gynecology and Department of Biochemistry of BSSMU, Dhaka to define any relation between the oral combined pill (OCP), bone mineral density (BMD) and serum alkaline phosphatase in pre and post menopausal women. A total of 100 closely matched healthy women were selected non-randomly. The age range was 35-55 years. Among them 50 were controls or nonuser and 50 were case or users of OCP. They were further subdivided into pre and postmenopausal groups. Bone density of the 100 women was measured in distal radius and ulna by single photon Absorptiometry Bone Densitometer DTX-100. Serum alkaline phosphatase was measured by reaction principle spectrophotometer UV 1201 Shimadzu by optimized standard method. It was found in this study that OCP users both pre and post menopausal women had lower level of mean alkaline phosphatase and higher mean BMD compared to non-users who had higher level of mean alkaline phosphatase and lower mean BMD. These data indicates that OCP non-users had elevated bone turn over, which appears to adversely influence BMD and fracture risk. It can be concluded that the most important non-contraceptive benefit of OCP may be positive effects on bone mass and combined biochemical and BMD screening may provide better prediction of future fracture risk than BMD alone.     

Effect of combined oral contraceptives on bone mineral density in pre and postmenopausal women

A retrospective urban-based cross-sectional study was done in the department of Pharmacology in collaboration with the department of Obs and Gynae of BSSMU, Dhaka, to define any relation between the OCP and BMD in pre and postmenopausal women. A total of 100 closely matched healthy women were selected non-randomly. The age range was 35-55 years. Among them 50 were controls or nonuser and 50 were case or users of OCP. They were further subdivided into pre and postmenopausal groups. Bone density of the 100 women was measured in distal radius and ulna by single photon Absorptiometry Bone Densitometer DTX-100. Statistically significant higher bone mineral density (BMD) was found in oral combined OCP users than non-users, both in pre and postmenopausal women. It can be concluded from this study that the most important non-contraceptive benefit of OCP may be positive effects on bone mass and thus reduced risk of postmenopausal osteoporosis and osteroporotic fracture.     

Oral contraceptives,serum folate,and hematologic status

Previous reports have suggested deleterious effects on folate balance in users of contraceptives. A study of folate in 526 women attending a family-planning clinic demonstrated, both with the Lactobacillus casei assay and with a new radioassay, that the mean serum folate level for women taking oral contraceptives was not significantly lower than that for women in a control group. There was no correlation between serum folate level and length of time oral contraceptives were taken. Also, there was no macrocytosis or hypersegmentation of polymorphonuclear leukocytes and no case of macrocytic anemia in the 280 users of oral contraceptive agents. Probably, oral contraceptive agents do not cause folate deficiency anemia in otherwise normal subjects.     

Malignant hypertension in women of childbearing age and its relation to the contraceptive pill

Eleven of 34 women aged 15-44 with malignant phase hypertension were taking oral contraceptives at presentation. All had had normal blood pressure before starting to take the pill. In four the interval between the start of oral contraception and the diagnosis of malignant hypertension was less than four months, and in eight no other cause for the hypertension was found. Underlying renal disease and renal failure were less common among pill users than among non-users with malignant hypertension who were of similar age. No pill user became normotensive after withdrawal of the pill, but blood pressure was well controlled (diastolic less than 90 mm Hg) in three patients taking only one drug. By contrast, all 23 non-users needed two or more antihypertensive drugs to control blood pressure. Ten year survival was 90% among pill users and 50% among non-users. These results suggest that oral contraceptives may be a common cause of malignant hypertension in women of child-bearing age. If the pill is stopped and underlying renal disease excluded the long term prognosis for such patients is excellent.     

Serum copper in rural women taking combined oral contraceptive

This prospective case-control study included 78 women between 15 to 45 years of age from rural area to see changes in serum copper level as a consequence of oral contraceptive use. Among the subjects, 34 women were included as controls because of not taking any form of hormonal contraceptives neither during the time of selection nor during one-year period prior to the study. Women in the control group were motivated to consume oral pill (Sukhi) for 3 consecutive cycles. At the 3(rd) month, 25 such women became available and henceforth included as cases on longitudinal basis. Another 44 women were randomly selected as cases on the basis of using combined oral contraceptives (Sukhi) for a duration of 4 months onwards. Considering different duration of oral contraceptive (OC) use, subjects were grouped as follows: Group I (n=34)--> controls, Group II (n=25)--> 3 months, Group III (n=17)--> 4 months - 2 years and Group IV (n=27)--> >2 years. Finally, 103 samples of blood (34 from controls and 69 from oral contraceptives users) were collected for estimation of Serum Copper (mgm/dl) by Atomic Absorption Spectrometry using UNICAM-AA Spectrometer. Mean+/-SD of Serum Copper significantly increased in all 3 contraceptive groups in comparison to controls (p<0.001). Further study including larger population from rural area was recommended to see correlation among serum copper and other trace elements with side effects of hormonal contraceptives. This preliminary study tried to explore the possibility of establishing biochemical monitoring of serum trace elements in OC users.     

Chronic inflammatory bowel disease, cigarette smoking, and use of oral contraceptives: findings in a large cohort study of women of childbearing age

Since the start in 1968 of the Oxford Family Planning Association contraceptive study 31 women have developed ulcerative colitis and 18 have developed Crohn's disease, giving incidences of 0.15 and 0.09/1000 woman years respectively. The incidence of ulcerative colitis in women who were non-smokers on entry to the study was 0.17/1000 woman years and the incidence in smokers was 0.11/1000 woman years. The findings for Crohn's disease were entirely different, the corresponding incidences being 0.05 and 0.17/1000 woman years respectively. Both ulcerative colitis and Crohn's disease were more common among women currently using oral contraceptives than among those not doing so. Incidences per 1000 woman years for ulcerative colitis were 0.26 in users and 0.11 in non-users; for Crohn's disease the incidences were 0.13 and 0.07 respectively. Though the association between the use of oral contraceptives and chronic inflammatory bowel disease cannot be regarded as established, the effects of smoking have been shown consistently in many studies. This observation provides an important clue to the aetiology of chronic inflammatory bowel disease.     

Post-pill anovulation.

Basal temperature records were maintained by 346 women after ceasing to take oral contraceptives; 167 had ceased using combined and 179 had ceased using low-dose sequential formulations. In the first cycle after withdrawal of low-dose sequential pills, 11 (6%) women failed to ovulate and ovulation was delayed in five cases. Short luteal cycles occurred in 14 subjects. In 83% of the subjects there was no disturbance of ovulation. In the first cycle after withdrawal of combined oral contraceptives, 49 (30%) women failed to ovulate and ovulation was delayed in 29 cases. A short luteal phase was observed in 26 subjects. In only 38% of the subjects was there no disturbance of ovulation. The minimal disturbance to ovulation in the cycle after the withdrawal of low-dose sequential formulation indicates that this type of oral contraceptive carries little risk of producing post-pill infertility. Women under the age of 21 years were anovulatory nearly twice as frequently as older women after ceasing to use combined oral contraceptives.     

Serum zinc status of rural women taking combined OC

This prospective case-control study was undertaken on 78 women between 15 to 45 years of age from rural area to see alteration of serum zinc due to oral contraceptive (OC) use. Of the subjects, 34 women was taken as controls having no history of taking any form of hormonal contraceptives neither during the time of selection nor during one-year period prior to the study. All of the women in the control group were advised to start consuming oral pill (Sukhi) for 3 consecutive cycles and at the 3(rd) month, 25 women were taken as cases on longitudinal basis. Another 44 women were randomly selected as cases on the basis of using combined oral contraceptives (Sukhi) for 4 months onwards. Subjects were classified as follows on the basis of duration of oral contraceptive use: Group I (n=34) -- controls, Group II (n=25) -- 3 months, Group III (n=17) -- 4 months -- 2 years and Group IV (n=27) -- >2 years. Finally, 103 samples of blood (34 from controls and 69 from oral contraceptives users) were collected for estimation of Serum Zinc (microg/dl) by Atomic Absorption Spectrometry using UNICAM - AA Spectrometer. MeanSD of Serum Zinc significantly reduced in all 3 contraceptive groups in comparison to controls (p<0.001). It was recommended to carry out further study including larger population from rural area to elucidate alteration in serum zinc and other trace elements to correlate with side effects caused by hormonal contraceptive so that attempt could be made to mitigate those.     

口服避孕药对血清催乳素及其胃复安兴奋试验的影响

本文报告756例口服短效避孕药Ⅰ号妇女血清催乳素(PRL)值及闭经、泌乳的发生情况,并与37例放置宫内节育器(IUD)妇女作对照。结果表明:长期服用短效避孕药Ⅰ号不引起血清PRL升高。24例接受胃复安兴奋试验表明,服药组的反应峰值较IUD组高(P<0.05),服药后闭经妇女对胃复安刺激的反应较前两者低,但尚属正常范围。     

Effects of prolonged use of injectable hormonal contraceptive on serum lipid profile

The current study was carried out to determine serum levels of total cholesterol, triacylglycerol (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in human female volunteers taking injectable hormonal contraceptives. For this purpose, 200 (two hundred) subjects with age range of 20-35 years were selected. Out of them, 140 (one hundred and forty) were experimental subjects and 60 (sixty) were control. Women without hormonal contraceptive were selected as the subjects of control group. The experimental subjects were taking injectable hormonal contraceptive, DMPA (depo-medroxyprogesterone acetate) for 3-5 years uninterruptedly. The mean serum total cholesterol and mean serum triacylglycerol levels of the DMPA users were significantly (P0.05). The mean serum LDL-cholesterol level of the subjects of DMPA users was significantly (P<0.05) elevated in comparison to that of the control.     

Pregnancy induced hypertension: evidence for increased cell membrane permeability to sodium

In a cross sectional study of 137 women of childbearing age (16-40) the effects of normal pregnancy, hypertensive pregnancy, and oral contraceptives on red cell electrolyte content and sodium efflux rates were examined and the results compared with values in a control group of normotensive, non-pregnant women. Efflux rate constants were significantly increased in normotensive pregnancy and in women taking oral contraceptives. This was associated with a significant increase in sodium permeability in the contraceptive group. A much larger increase in sodium permeability and efflux rate constant was seen in the hypertensive group. The results permit a hypothesis that the hormonal changes induced by pregnancy and oral contraceptives increase membrane permeability to sodium and stimulate sodium efflux. The rise in blood pressure associated with use of oral contraceptives may have a similar aetiology to that occurring in pregnancy induced hypertension.     

Vitamin A,pregnancy, and oral contraceptives

It has been shown that women receiving oral contraceptives have increased levels of serum vitamin A. High vitamin A levels may constitute a teratogenic hazard. Women who conceive soon after discontinuing oral contraceptive therapy may be especially at risk to this hazard. An increase in vitamin A levels in women taking oral contraceptives has been confirmed. During early pregnancy there is no significant difference in vitamin A levels between women who have recently been taking oral contraceptives and those who have not. The authors were not able to demonstrate that either taking oral contraceptives shortly before pregnancy or a high vitamin A level during the first trimester of pregnancy, comparable to that of a woman taking oral contraceptives, has any detrimental effect on the outcome of pregnancy. It seems unlikely that women conceiving soon after discontinuing oral contraceptive, has any detrimental effect on the outcome of pregnancy. It seems unlikely that women conceiving soon after discontinuing oral contraceptive therapy run any teratogenic risk from increased vitamin A levels.     

The effect of long term use of oral contraceptive pills on lipid metabolism

The effect of long-term use of oral contraceptive pills on lipid metabolism was the aim of this study. 200 healthy, multiparous women attending the family planning clinic in Ain Shams University Hospital, Cairo, were divided into two groups. The study group included 100 women using monophasic combined oral contraceptive pills, while the control group included 100 women using only IUDs for at least 5 uninterrupted years. Serum total lipids, cholesterol, triglycerides, and lipoproteins were estimated in both groups. It was found that serum cholesterol, triglycerides, and beta-lipoproteins were higher in pill users than in the IUD group. The level of alpha-lipoproteins showed a more significant drop in the serum of pill users than in the serum of the control group. None of these changes were correlated with body weight or duration of pill usage. The estimated serum level of total lipids was found to be high among pill users and not correlated with the duration of pill usage. This rise was insignificant in pill users having body weight less than 70 kg, but was significant in all other body weight groups.     

Association between diaphragm use and urinary tract infection

We conducted independent case-control and retrospective cohort investigations to assess the relationship between diaphragm use and urinary tract infection (UTI). In the former, we compared diaphragm use and vaginal flora among 114 women with acute UTI and 85 women with acute urinary tract symptoms and no UTI. In the latter study, we ascertained the incidence of UTI in 192 diaphragm users and 182 women taking oral contraceptives during a mean follow-up of 9.4 months. Both studies demonstrated a significantly increased risk of UTI in diaphragm users: relative odds were 2.0 in the case-control study and the relative risk was 2.5 in the retrospective cohort study. Vaginal colonization with Escherichia coli was significantly greater in diaphragm users. The incidence of UTI in the cohort study was 26.6 per 1,000 patient-months for diaphragm users and 8.9 per 1,000 patient-months for women taking oral contraceptives. The increased risk of UTI in diaphragm users could not be attributed to differences in age, parity, sexual activity, or previous UTI.     

Post-pill infertility.

One hundred and fifty-one nulligravid women and 63 parous women stopped taking low-dose sequential oral contraceptives in order to become pregnant. During the first post-Pill cycle, 39% of the nulligravid and 54% of the parous women conceived. These figures have been compared with data from the Royal College of General Practitioners survey in England, in which 13% of nulligravid and 17% of parous women conceived in the first cycle after ceasing to take combined oral contraceptives. The percentage of nulligravid women not pregnant six months after withdrawal of low-dose sequential formulations was 19% compared with 32% after withdrawal of combined oral contraceptives. The corresponding figures for parous women were 5% and 21%. Available data suggest that after withdrawal of low-dose sequential oral contraceptives, the incidence of post-Pill infertility is lower than that after withdrawal of combined oral contraceptives. The extent of this difference is 16% three months after withdrawal of the Pill and 10% six months after attempting pregnancy.     

Oral contraceptives, pregnancy, and endogenous oestrogen in gall stone disease--a case-control study

A case-control study of gall stone disease in women in relation to use of contraceptives, reproductive history, and concentrations of endogenous hormones was undertaken. The study population comprised 200 hospital patients with newly diagnosed gall stone disease, 182 individually matched controls selected from the community, and 234 controls who were patients in hospital. Use of oral contraceptives was associated with an increased risk of developing gall stones among young subjects but a decreased risk among older subjects. The risk of developing gall stone disease increased in association with increasing parity, particularly among younger women. The risk fell with increasing age at first pregnancy, independent of parity. Mean urinary excretion over 24 hours of oestrone, but not of pregnanediol, was significantly (p less than 0.05) greater for postmenopausal patients than controls. The age dependence of the relative risk associated with exposure to oral contraceptives and pregnancy suggests that there are subpopulations of women susceptible to early formation of gall stones after exposure to either oral contraceptives or pregnancy.     

Cancer of the liver and the use of oral contraceptives

A case-control study of the use of oral contraceptives was conducted among women certified as having died from cancer of the liver in the period 1979-82 and in the age range 20-44 years. An age matched group of women who died from other causes, not related to use of oral contraceptives, in the same period were used as controls. Information about use of oral contraceptives was obtained from the general practitioners' notes for both cases and controls. Information was obtained for 30 women with histologically confirmed liver cancer, 19 with hepatocellular carcinoma and 11 with cholangiocarcinoma, and for 147 controls. The results were analysed after adjusting for age at diagnosis and year of birth and showed that use of oral contraceptives was associated with a significantly (p less than 0.05) raised relative risk for hepatocellular carcinoma of 3.8 (95% confidence interval 1.0 to 14.6) and use for eight years or more was associated with a significantly (p less than 0.01) increased relative risk of 20.1 (2.3 to 175.7). There were no apparent increases in risk for cholangiocarcinoma. Despite the small number of cases in this study and the methodological problems in assessing use of oral contraceptives from general practitioners' notes, the results were consistent with other similar studies. Although in the United Kingdom primary liver cancer remains an exceptionally rare disease, especially in young women, further research on the role of oral contraceptives is needed in those countries where it is a much more common disease.     

人工流产术后立即服用避孕药360例临床分析

目的探讨人工流产术后立即口服避孕药的安全性、必要性及临床疗效。方法对泸州市江阳区妇幼保健院2008年6月至2009年4月行人工流产术的早孕患者360例进行研究：研究组240例立即口服避孕药（特居乐）;对照组120例采用其他避孕方法。观察分析2组患者术后阴道流血时间、出血量、月经转归和阴道分泌物等情况。结果研究组的阴道出血量及持续时间、子宫复旧情况、月经周期恢复情况、避孕的效果优于对照组（P〈0．05）。口服短效避孕药者无明显不良反应。结论人工流产术后立即口服短效避孕药将有助于减少术后流血、预防感染,有益于育龄期妇女的身心健康。     

Oral contraceptives may tend to protect against benign breast cancer

A retrospective epidemiological study was made of all women of reproductive age admitted to 5 London hospitals for primary treatment of breast cancer or biopsy of a mass in the breast. The only significant difference was that the benign disease group had used oral contraceptives about half as long as the controls. 12% of the women with benign breast lesions used oral contraceptives the month immediately preceding discovery of the breast mass. 22% of the Controls used the contraceptives during the corresponding month.