[Advantages and risks of hormonal contraception]

Among modern contraceptive methods hormonal contraceptive agents, due to their reliability, are preferred. Nevertheless, it has to be considered that these steroidal hormones and their metabolites do not only possess an ovulation inhibitory effect, but that they also influence other systems, such as carbohydrate and lipid metabolism, blood clotting, fluid balance, plasma proteins as well as the entire hormonal system. These multiple side effects have positive and negative influences. By reducing the doses of estrogens and progestagens occurrence of unpleasant adverse reactions has been decreased. Some years ago, the estrogen content of oral contraceptive preparations was considered to be noxious while a favourable effect was attributed to the progestagen content. The results of biochemical studies yielded a better understanding of the effect of steroidal hormones on lipid metabolism. Fertility problems occurring after discontinuation of oral contraceptive treatment are mainly observed in women who, prior to use of oral contraceptive agents have already been suffering from functional cycle disturbances. Ovulation inhibitory preparations may also be given to adolescent girls with immature cycles. As the juvenile endocrine system is adaptable, after cessation of the ovulation inhibitory effect, the cycle returns to pretreatment patterns. It may now even be possible to administer hormonal contraceptive agents to treat endocrine disturbances.