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[Internal medicine problems regarding contraception. Part I]

M Mall-Haefeli

    Schweizerische Medizinische Wochenschrift
    |September 6, 1980
    PubMed
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    Modern hormonal contraceptives use significantly lower hormone doses, reducing adverse reactions like thromboembolism and hypertension. Careful selection of oral contraceptive agents can mitigate risks such as glucose deterioration and hepatic complications.

    Area of Science:

    • Reproductive health
    • Endocrinology
    • Pharmacology

    Background:

    • Public perception of oral contraceptives is influenced by media and patient anxieties.
    • Historical oral contraceptive formulations contained higher steroidal hormone doses.
    • Adverse event rates have decreased with the development of lower-dose formulations.

    Purpose of the Study:

    • To evaluate the safety profile of contemporary hormonal contraceptive agents.
    • To compare risks associated with different oral contraceptive formulations.
    • To identify contraindications for oral contraceptive use.

    Main Methods:

    • Review of adverse reaction data associated with hormonal contraceptive agents.
    • Analysis of dose-dependent effects of ethinylestradiol (EE) and gestagens.
    Keywords:
    BiologyBlood Coagulation EffectsCarbohydrate Metabolic EffectsCardiovascular EffectsContraceptionContraceptive Methods--contraindicationsFamily PlanningFibrinolysisHematological EffectsHemic SystemHepatic EffectsHypertensionLipid Metabolic EffectsLiterature ReviewOral Contraceptives--contraindicationsPhysiologyThromboembolism

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  • Categorization of absolute and relative contraindications.

    • Main Results:

    • Lower doses of ethinylestradiol (EE) in ovulation inhibitors (e.g., 50 gamma EE, 30 gamma EE micropills) significantly reduce thromboembolism risk.
    • Hypertension occurs in 1-2.5% of users, manageable with regular blood pressure monitoring.
    • Glucose tolerance is influenced by estrogen dose and gestagen type; low-dose agents with pregnane-type gestagens or minipills minimize glucose deterioration risks.
    • Increased plasma triglycerides and hepatic complications (jaundice, pancreatitis) are potential risks, particularly with longer treatment durations and C17-alkyl substituted steroids.
    • Oral contraceptives demonstrate a protective effect in rheumatoid arthritis.

    Conclusions:

    • Modern low-dose hormonal contraceptives offer a significantly improved safety profile compared to older formulations.
    • Risk management involves careful patient selection, regular monitoring, and appropriate formulation choice.
    • Contraindications must be considered to ensure safe and effective use of oral contraceptive agents.