Origin of sympathetic and sensory innervation of the endolymphatic sac. A retrograde axonal tracing study in the guinea pig.

Lectin-conjugated horseradish peroxidase (WGA-HRP) was used as a retrograde axonal tracer to determine endolymphatic sac (ES) innervation and the nature of such a nervous supply. WGA-HRP placed into the ES of the guinea pig resulted in labelling of neurons in the ipsilateral sympathetic superior cervical ganglion and the sensory trigeminal ganglion. The number of labelled neurons in the cervical superior ganglion varied according to the survival time with peak labelling occurring after 48 h. Sparse labelling of the sensory trigeminal ganglion was also present after 48 h. The results indicate that sympathetic neurons from the superior cervical ganglion and to a certain extent trigeminal somatosensory neurons innervate the ES or perisaccular tissue. If these findings reflect the existence of a sympathetic functional reflex unit remains to be elucidated.

Modern oral contraceptives and dysmenorrhoea.

Women with primary dysmenorrhoea not sufficiently helped by triphasic oral contraceptives (OCs) were offered a modern, low-dose monophasic OC containing 30 micrograms of ethinylestradiol and 150 micrograms of desogestrel. The study shows that for these women, the monophasic pill was the better alternative. The fact that 19 of 23 women who continue treatment on the monophasic OC indicates that this type of pill may be chosen as the first alternative for women with primary dysmenorrhoea.

PIP: The effectiveness of a monophasic oral contraceptive was compared to that of a triphasic for relief of primary dysmenorrhea in an open crossover study in 30 women who had been previously taking triphasics. The pills formerly used contained ethinyl estradiol and either norethisterone (3) or levonorgestrel (27). Women took the monophasic pill containing 150 mcg desogestrel and 30 mcg estradiol [sic] for 3 months, then resumed their former prescription. Dysmenorrhea pain, marked on 10 mm scale, was lessened in 18 and increased in 4 women during monophasic intake (p0.01). Total duration of pain was reported as 2081 hours on the monophasic, and 2237 hours on the triphasic. The amount of bleeding reported as light, medium or heavy on a calendar was less on the monophasic for 18 women, the same in 2 and less on the triphasic for 4 women. Analgesic use during the monophasic was reported as less by 13, the same by 1, and more by 6 women. 19 women expressed a desire to continue with the monophasic after the study. It is likely that monophasic pills relieve dysmenorrhea more effectively because of their more consistent inhibition of ovulation.