contraceptives--postcoital and Metabolic-Diseases

Hormonal contraceptives will continue to be used for some time to come as the safest means by which to prevent pregnancy. This is the background against which an account is given of the forms of hormonal contraception, their safety, selection of preparations, prescription for young people, side-effects, contra-indication to prescription, and indication for discontinuation.--In the context of side-effects, particular reference is made to the effects of steroids upon fat, carbohydrate, and protein metabolism, the cardiovascular system, and early pregnancy.. A review of the composition and side effects of the various types of hormonal contraceptives (h.c.'s) is presented. The Life Table Method is preferred for determining the efficiency of h.c.s. Combination, sequential, and depot preparations contain both estrogen and gestagen components, and work to inhibit ovulation. Mini-pills consist solely of a low-dosage gestagen, and work to increase the viscosity of the cervical secretions to hinder sperm penetration. "Morning-after pills" can contain either an estrogen or gestagen alone or a combination of both; the relatively high dosages of hormones in these preparations work to inhibit nidation. The use of other medications such as sedatives, anti-epileptic agents, or analgesics can interfere with the effectiveness of h.c.s. H.c. use should be interrupted for 2-3 cycles every 2 years to assure normal ovarial function. H.c. users should have health check-ups every 6 months. H.c.s can be prescribed to adolescents 2 years after menarche if the menstrual periods have been regular fora year. Tables listing various side effects of h.c. use and contraindications for h.c. use are presented. H.c.s can affect the menstrual cycle; the metabolism of lipids, proteins and carbohydrates; and the circulatory system. The effect of h.c. use on the incidence of malignant cervical, endometrial, and breast tumors has not been established. Benign breast tumors develop less frequently among h.c. users, while benign liver tumors are more frequent.

Topics: Cardiovascular Diseases; Contraceptives, Oral; Contraceptives, Oral, Hormonal; Contraceptives, Postcoital; Female; Hematologic Diseases; Humans; Metabolic Diseases; Pregnancy