ABSTRACT
The combined oral contraceptive pill is an efficient means of contraception. It acts at different levels of the genital tract. Despite its efficiency, it is universally suggested that patients take the pill at regular daily intervals. Little attention has been given to the question of what happens if you miss the pill one day or more. A study was undertaken to evaluate the consequences of pill misses at different times of the cycle. Forty-seven young, healthy, normally menstruating patients voluntarily enrolled. All were given Cilest (ethinyl estradiol 35 micrograms and norgestimate 250 mg, Cilag France) for 21 days without any misses. Then, after a 7-day interval, they were prescribed one (group 1), two (group 2), three (group 3) or four days of pill misses, to occur respectively on day 1 (group a), 6 (group b), 12 (group c) or 18 (group d) of a new 21 day cycle; supplementary contraceptive means were recommended. Four patients had no miss prescribed and served as controls. Ovarian function was evaluated with daily estrogen measurements (E1 + E2 enzymatic dosage, BioMérieux, France) and ultrasound examinations. When required, because of significant increase in estrogen or because of follicular growth detected on ultrasound, LH and progesterone were measured. None of the patients experienced a normal ovulation. Four patients (1 control, 1 from group 2a, and 2 from group 3a) had a significant increase in estrogen levels and had a follicular image on ultrasounds. One of them (group 3a) had a follicular rupture, but none had a LH surge or increase in progesterone.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Contraceptives, Oral, Combined/administration & dosage , Ovary/physiology , Adolescent , Adult , Estrogens/urine , Female , Humans , Luteinizing Hormone/urine , Ovary/diagnostic imaging , Ovulation/physiology , Progesterone/blood , UltrasonographyABSTRACT
PIP: A systematic study was undertaken in order to evaluate the consequences of missing oral contraceptives (OCs) at different times in the cycle. 39 young, healthy, normally menstruating patients were voluntarily enrolled in this study and all were given Cilest (ethinyl estradiol 35 mcg + norgestimate 250 mcg, Cilag, France) for 21 days without any gaps. Then, after a 7-day interval, they were prescribed 1 (group 1), 2 (group 2), 3 (group 3), or 4 (group 4) days of OC misses. These occurred on day 1 (class a), day 6 (class b), day 12 (class c), or day 18 (class d) of a 21 day Cilest cycle. In addition, supplementary contraceptive measures were recommended to those participating. With 47 cycles examined, 5 patients had no miss prescribed and this group served as the controls. Ovarian function was evaluated with daily estrogen monitoring (E1 + E2 enzymatic dosage, Bio Merieux, France) and ultrasound examination. When necessary, due to a significant estrogen increase or follicular growth detected on ultrasound, progesterone and LH were measured. 9 patients showed a follicular image on ultrasound. 4 patients (1 control, 3 others ) had a significant increase in estrogens and 2 others had no secretions. All the others had no manifestation of restoration of ovarian function. None of the 9 patients had a normal ovulation (no LH surge or increase in progesterone). Blockage of ovarian function by OCs remains efficient even after several days of OC missing. (author's modified)^ieng
Subject(s)
Contraception , Contraceptives, Oral, Combined , Luteinizing Hormone , Ovary , Progesterone , Research Design , Ultrasonics , Biology , Contraceptives, Oral , Developed Countries , Endocrine System , Europe , Family Planning Services , France , Genitalia , Genitalia, Female , Gonadotropins , Gonadotropins, Pituitary , Hormones , Physiology , Progestins , Research , Urogenital SystemABSTRACT
The combined oral contraceptive pill is an efficient means of contraception. It acts at different levels of the genital tract. Despite its efficiency, it is universally suggested that patients take the pill at regular daily intervals. Little attention has been given to the question of what happens if you miss the pill one day or more. A study was undertaken to evaluate the consequences of pill misses at different times of the cycle. Forty-seven young, healthy, normally menstruating patients voluntarily enrolled. All were given Cilest (ethinyl estradiol 35 micrograms and norgestimate 250 mg, Cilag France) for 21 days without any misses. Then, after a 7-day interval, they were prescribed one (group 1), two (group 2), three (group 3) or four days of pill misses, to occur respectively on day 1 (group a), 6 (group b), 12 (group c) or 18 (group d) of a new 21 day cycle; supplementary contraceptive means were recommended. Four patients had no miss prescribed and served as controls. Ovarian function was evaluated with daily estrogen measurements (E1 + E2 enzymatic dosage, BioMérieux, France) and ultrasound examinations. When required, because of significant increase in estrogen or because of follicular growth detected on ultrasound, LH and progesterone were measured. None of the patients experienced a normal ovulation. Four patients (1 control, 1 from group 2a, and 2 from group 3a) had a significant increase in estrogen levels and had a follicular image on ultrasounds. One of them (group 3a) had a follicular rupture, but none had a LH surge or increase in progesterone.(ABSTRACT TRUNCATED AT 250 WORDS)
