Indocyanine green liver function studies on women taking progestins

The liver extraction of indocyanine green in concentrations of 0.2 mg./kg. and 0.5 mg./kg. in women taking oral contraceptive (norethindrone 2 mg. with mestranol 0.1 mg., and norethindrone 1 mg. with mestranol 0.05 mg.) is reported. No major alteration was noted in the hepatic function with the plasma concentrations of the dye employed. The probability of increased hepatic arterial flow or increased cardiac output due to norethindrone-mestranol combination is noted. The value of indocyanine green in the study of liver dysfunction is stated and its relative sensitivity at various concentrations is mentioned. The use of indocyanine green to predict early hepatic changes in toxemia of pregnancy, especially in those patients with excessive weight gain, is suggested.

Ovarian changes after long-term oral contraception

A study was made of ovarian tissue, obtained from 5 women who had used an oral contraceptive during 4–30 cycles. Intra-ovarian signs of follicle growth and follicle maturation were found in 4, and hyperthecosis was present in 3 subjects. These changes are an indication of FSH and LH activity. Ovarian fibrosis was found in the 3 women who had used ovulation inhibitors for 12 or more cycles: thickening of the tunica albuginea was present in 3 and fibrosis of the cortical stroma in 2 of these women.

The effect of the long term administration of oral contraceptives on excretion values for follicle-stimulating hormone and luteinising hormone

Pituitary gonadotrophic function together with urinary steroid excretion has been studied in four women during and following long term therapy with oral contraceptives. Assays of follicle-stimulating hormone (FSH) were performed in all subjects while luteinising hormone (LH) output was measured in two.

Estimations of urinary oestrogens and pregnanediol indicated absence of ovarian activity during treatment and the resumption of ovulation in the first or second post-treatment cycle.

In the three women who received progestogen-oestrogen mixtures depression of FSH and LH activities during treatment was noted. In the subject receiving a progestogen alone such a depression did not occur.

Following withdrawal of medication urinary FSH excretion remained similar to that during treatment while LH levels either rose or were unchanged.

It is concluded that the long term effects of oral contraceptives on pituitary gonadotrophic function are variable and may depend on such factors as the composition of the tablet administered, its total dosage and the duration of therapy.