Twenty years of oral contraception.

PIP: This is a survey article on the development of OCs (oral contraceptives). It traces OC development and research through the original combined synthetic estrogen-synthetic progestagen, the sequential regime, the progestagen-only preparation, and injectable hormonal agents, Clinical studies performed with different preparations of OC are cited. Adverse effects which have been shown to be associated with OC usage are mentioned. Acceptability of OCs, despite adverse publicity, has grown. It is predicted that the popularity of OCs will rise once again, particularly after publication of the results of certain studies which show that the cardiovascular hazards associated with OCs are not confirmed. Removal of OCs from restricted medical distribution will also tend to increase their popularity.^ieng

[Clinical studies on Ovostat--a combined oral contraceptive with a low dose of lynestrenol]. / Klinische Untersuchung mit Ovostat--einem kombinierten oralen Kontrazeptivum mit einer niedrigen Dosis Lynestrenol

PIP: Experience with the oral contraceptive Ovostat (.1 mg mestranol and 1 mg lynestrenol) in 324 women (5714 cycles) is reported. Only 1 pregnancy was observed, in a patient who had forgotten several pills. Side effects included headache (11 patients), nervousness (5 patients), amenorrhea (4 patients), and chloasma (3 patients). Breakthrough bleeding and spotting were rare. Cervical mucus (samples on Days 9-11 and 13-15 in 50 women) was uniformly inhospitable to sperm: low viscosity, negative Farn test, constant pH. Endometrial biopsy showed tissue typical of "suppressed" endometrium.^ieng

Ovarian morphologyy after prolonged use of steroid contraceptive agents.

PIP: To assess the effect of oral contraceptives on ovarian morphology, 125 users (average age 30) and 42 controls (average age 24) were studied histologically. The duration of the steroid treatment in the 125 subjects varied from 2 to 91 months. 60 used combination oral contraceptives, 28 used sequential, 21 received depot progestins, and 16 used continuous low dose progestin. Investigation was directed to the presence or absence of the various ovarian structures. In all specimens primary follicles were seen. Women using combined and depot progestins showed disturbance in the secondary follicles development. Tertiary follicles were common in the low dose progestin, occurring occasionally with sequential and combination treatment, and never with depot progestin. Ovaries from steroid treated patients appeared to have a large number of atretic follicles with cystic dilatations. An increase in ovarian connective tissue occurred in half of the cases using combined preparations, one third of those using sequential, and almost all of those using depot progestin.^ieng

Norgestrel and ethynyl estradiol: a new low-dosage oral agent for fertility control.

PIP: To study the safety and efficacy of a norgestrel-ethinyl estradol oral contraceptive compound, 300 Mexican women, 16-42 years of age were orally administered .5 mg norgestrel and .05 mg ethinyl estradiol (Ovral) daily over a total of 3175 study cycles. Most of the women were poor., uneducated and of high parity. None of the patients in the study became pregnant, even in the cycles where 1 or more doses were omitted. The menstrual cycle remained basically unaltered with breakthrough bleeding or spotting sometimes reported, usually when doses were missed. Unexplained amenorrhea occurred in 1.2% of the cycles. Though 5% of the women were ovulatory at one time of another as determined by pregnandiol levels, no pregnancy resulted, which is probably explained by changes in the cervical mucus caused by the pills making an inhospitable environment for sperm migration. Psychosomatic-related side-effects included nausea, headache and decreased libido in less than 1% of the cycles. Chloasma aggravated by poor dietary intake occurred in .5% of the cycles. No malignant, peripheral vascular or other serious disease occurred during the treatment and no significant endometrial alterations were seen.^ieng