Urinary hormonal profile during the first cycle of low-dose oral contraceptive pills in women.

Ovarian function was studied in ten normal fertile women before and during the first cycle on a low-dose micropill containing 30 mcg ethinyl estradiol and 150 mcg L-norgestrel. In a control cycle and the first treatment cycle, steroid metabolites estrone-3-glucuronide (E1-3G) and pregnanediol-3 alpha-glucuronide (Pd-3G) were measured in daily early morning urine (EMU) samples. Also, luteinizing hormone (LH) was estimated during the expected periovulatory period. During the first cycle of micropill intake, ovarian function was suppressed in all cases. This is evidenced by significantly lower E1-3G and Pd-3G and absent midcycle LH peak compared to control cycles. The pattern of steroid metabolites was almost flat with no peaks. It is concluded that there is no need to cover the first cycle of micropill intake with other contraceptive methods.

The effect of vaginal administration of low-dose oral contraceptive tablets on human ovulation.

The effect of vaginal administration of a low dose combined oral contraceptive pill containing 0.15 mg levonorgestrel and 0.03 mg ethinyl oestradiol was studied in twenty women for a total of 58 cycles. Ovulation was suppressed in all treatment cycles in women receiving two pills daily. Failure of suppression of ovulation occurred in four out of 26 treatment cycles in women receiving one pill daily. Only seven women complained of side effects; most of the side effects were mild and disappeared gradually within the first treatment cycle. Intermenstrual spotting was present in only one case receiving one pill daily. It is concluded that vaginal administration of low dose combined pills has a good ovulation suppression effect with minimal side effects and with good cycle control.

Effect of aspirin on the luteal phase of human menstrual cycle.

The effect of aspirin (acetylsalicylic acid) on the luteal phase length and function was studied in ten normal cycling women. They received three grams daily for twenty days starting from the fifth day of the cycle. Urinary pregnanediol-3 alpha-glucuronide (Pg-diol- 3G ) and luteinising hormone (LH) were assayed in daily early morning urine samples together with daily vaginal smear for cytohormonal evaluation. The excretion profile of Pg-diol- 3G and LH of another group of ten normal women were taken as controls. Aspirin caused shortening of both cycle length and luteal phase duration. Available evidence suggests the presence of corpus luteum deficiency in the treated cycles.

Management of amenorrhea due to contraceptive injectables by temporary IUD insertion.

Amenorrhea is a common side effect of injectable contraceptive. Lippes loops were inserted in 22 amenorrheic women who continued injectable contraception, and in 6 cases with prolonged postinjectable amenorrhea. The occurrence and rhythm of subsequent bleeding was recorded. IUD insertion induced bleeding in most cases of continued injectable users but it was usually irregular and unpredictable. It was regular in 6 subjects only while the IUD was in situ. After the removal of the IUD, the majority regained the state of amenorrhea within 3 months. Temporary IUD insertion had a positive impact on continuation (a mean additional rate of 18 months of use) among subjects who had wished to terminate the method because of amenorrhea. This procedure of temporary IUD insertion may serve to provide these women with an alternative contractive approach. In the postinjectable amenorrhea group, temporary IUD insertion induced bleeding during IUD application as well as after its removal, which was more predictable than that in the continued users. IUD insertion may facilitate return of regular menses and resumption of fertility in amenorrheic women who stop injectable contraception.

Induction of human luteolysis by high dose infusions of 150methyl PGF2 alpha.

Previous data in the human generally indicate that therapeutic doses of prostaglandins (PGs) are not luteolytic. In an attempt to evaluate whether a high dose infusion (approx. 5 microgram/min for 6 hours) of a potent PG (15-methyl PGF2 alph) analogue is luteolytic, 15-methyl PGF2 alpha was administrated in the mid-luteal phase of 10 normally menstruating volunteers. The infusion induced a significant and sustained luteolytic response in 8 subjects as evidenced by a drop in progesterone levels and premature menstrual-like bleeding. In the other two cases luteal recovery was apparent from the regained normal plasma levels of progesterone and a normal cycle length. Thus, it can be concluded that luteolysis can be induced in humans by this PG provided that high dose infusions are utilized which also cause a lot of undesirable side-effects.