Oral contraceptives: effects on carbohydrate metabolism, insulin like activity and histology of the pancreas

The effect of the combination type oral contraceptive and its estrogen (mestranol) and progesterone (ethynodiol diacetate) components on the intravenous glucose tolerance test (IVGTT), intravenous tolbutamide test (IVTT), serum insulin like activity (ILA) and morphology of beta cells of the pancreas was investigated in female rabbits. The combination produced impairment of glucose tolerance in all animals after 24 weeks treatment. Fifty percent of animals in the estrogen treated group and 33.3 percent of animals in the progesterone treated group developed impairment of glucose tolerance after 24 weeks. A reduction in the glucose response to IVTT was observed in all the animals following 24 weeks treatment with the combination, estrogen or progesterone. A significant decline in fasting serum ILA and post glucose ILA was observed in animals treated with the combination and estrogen. A small but consistent decline in the serum ILA was observed in animals treated with ethynodiol diacetate. A rise in serum FFA paralleled the abnormality of glucose tolerance. Morphological changes in the cytostructure of pancreatic islets in the form of degranulation and degeneration of cells were observed in the pancreas of animals treated with the combination, and to lesser extent in animals treated with estrogen and progesterone. These observations indicate that the disturbances in carbohydrate and lipid metabolism produced by oral contraceptives may be associated with damage to beta cells and low circulating insulin in rabbits.

Temporal changes in metabolism of norepinephrine in rats following administration of estrogen

1. Temporal changes in the metabolism of norepinephrine (NE) were found in female rats following the administration of estrogen (15 micrograms biweekly) for 3 weeks, in regions of the brain believed to be involved in the control of blood pressure. 2. While treatment with a relatively low dose of estrogen did not have any significant overall effect on the release of hypothalamic NE it was previously found that synthesis of NE in this region of the brain in estrogen-treated rats occurs only in the late-dark period when the maximum level in blood pressure occurs. 3. Although it is known that NE synthesis takes place in the medial lower brainstem during the late-dark period in estrogen-treated and control rats, no significant release of NE from this region of the brain was found at any of the 3 times sampled, 1 1/2 h following the administration of amphetamine. 4. Estrogen appears to abolish the release of cerebellar NE which occurs at the late-dark phase in control rats. This finding is consistent with the previously reported absence of NE synthesis at late-dark and early-light phases following estrogen administration, and 1 1/2 h after the injection of alpha-methyl-p-tyrosine. 5. No temporal differences in the release of adrenal NE at the sampled times were found, although such changes have been observed to occur in adrenal NE biosynthesis in estrogen-treated rats. 6. Following administration of amphetamine, temporal differences were found in cardiac NE levels at late-dark and mid-light phases in both estrogen-treated and control rats.

Plasmatic and vascular factors of the hemostatic system in rats receiving an estrogen-progestogen combination

Treatment of rats for 10 estral cycles with an estrogen-progestogen combination giving 100% infertility triggered a vascular response characterized by increased prostacyclin activity in arterial walls and increased systolic blood pressure. In contrast, plasma fibrinolytic activity and physiological coagulation inhibitors as well as vascular fibrinolytic activity were not changed by this treatment. The same rats tended to have shorter occlusion times of an aortic prosthesis, and could represent a useful model to study the blood-vessel-wall interplay during oral contraceptive treatment.

Serum levels of ethinylestradiol following its ingestion alone or in oral contraceptive formulations

The pharmacodynamics of ethinylestradiol (EE2) were studied utilizing a specific radioimmunoassay to measure serum levels in subjects ingesting EE2 alone or in combination with various gestagens. Following the administration of a single oral dose of 20 micrograms of EE2 to three postmenopausal women, peak serum levels ranging from 29 to 58 pg/ml were reached within one hour. Levels fell below the sensitivity of the assay (20 pg/ml) 2, 5 and 8 hours after ingestion. In normal menstruating women, peak serum EE2 concentrations averaged 84 +/- 27 pg/ml after the ingestion of 35 micrograms EE2 and 0.5 mg norethindrone, 152 +/- 57 pg/ml after the ingestion of 50 micrograms mestranol and 1.0 norethindrone and 201 +/- 11 pg/ml after the ingestion of 50 micrograms EE2 and 0.5 mg norgestrel. After the ingestion of mestranol, peak serum levels of EE2 were less than and occurred later than peak levels obtained after the ingestion of the same dose of EE2.

Oral contraceptive steroids: effects on iron and zinc levels and on tryptophan pyrrolase and alkaline phosphatase activities in tissues of iron-deficient anemic rats

Weanling Wistar-strain female rats were fed a normal or an iron-deficient diet for 8 weeks and oral contraceptive steroids (OCS) were added for the last 4 weeks. Hemoglobin content, serum iron and zinc levels, liver iron levels, and tryptophan pyrrolase activities, and liver, kidney, and brain zinc levels and alkaline phosphatase activities were determined. Compared to control rats given the normal diet (N group), elevated liver zinc levels and tryptophan pyrrolase activity were found in rats fed the normal diet containing OCS ( + S group), but other parameters did not alter. In rats fed the iron-deficient diet alone (D group), only liver zinc levels were significantly higher, while other parameters were in general lower than those in the N group. In rats fed the iron-deficient diet containing OCS (D + S group), all hematological values, tissue mineral contents with the exception of liver zinc levels, and liver tryptophan pyrrolase and kidney alkaline phosphatase activities were lowered, compared to the N or N + S group. However, compared to the D group, the values of most parameters in the D + S group did not differ significantly, apart from an increase in serum zinc levels. These observations suggest that OCS does not greatly influence the various changes caused by iron-deficient anemia.

Effects on sex hormone binding globulin of different oral contraceptives containing norethisterone and lynestrenol

Six combined oral contraceptive drugs containing ethinyloestradiol or mestranol and norethisterone or lynestrenol were studied throughout six 21-day cycles in healthy female volunteers. There was always one menstrual cycle without treatment between every treatment cycle. Plasma levels of norethisterone were determined throughout treatment by use of a specific radioimmunoassay. Sex hormone binding globulin (SHBG) was measured by an ammonium sulphate precipitation method at the beginning and at the end of each treatment cycle. The results indicated an accumulation of norethisterone in plasma when 1 to 3 mg of norethisterone or lynestrenol was given. There was no obvious accumulation during treatment with 0.5 mg norethisterone. SHBG increased during treatment with all combinations studied. However, this increase was most pronounced with the 50 microgram ethinyloestradiol/l mg lynestrenol, 50 microgram mestranol/l mg norethisterone and 35 microgram ethinyloestradiol/0.5 mg norethisterone combinations. There was no statistically significant increase in SHBG with 50 microgram ethinyloestradiol/2.5 mg lynestrenol or 50 microgram ethinyloestradiol/3 mg norethisterone acetate combinations. The results indicated that the induction of SHBG by the synthetic oestrogens was antagonized by the progestogens in a dose-dependent manner. The effect on SHBG by a combind preparation could be one assessment of the oestrogenicity or androgenicity of the preparation.

Comparison of metabolic and clinical effects of four oral contraceptive formulations and a contraceptive vaginal ring

A group of 100 women desiring OC received one of the following four formulations on a randomized basis: (1) mestranol 50 micrograms and norethindrone 1 mg, , (2) ethinyl estradiol 50 micrograms and norethindrone 1 mg, (3) ethinyl estradiol 35 micrograms and norethindrone 1 mg, and (4) ethinyl estradiol 30 micrograms and levonorgestrel 150 mg. An additional 10 women received a CVR containing levonorgestrel and estradiol. Measurement of a large number of serum chemistries, lipids, proteins, clotting factors, and liver enzymes was obtained before and 3 and 6 months after starting medication. Clinical factors such as weight, blood pressure, bleeding or spotting, or any adverse side effects were also recorded. There was no significant difference in the metabolic parameters measured among the four oral contraceptives except the increase in angiotensinogen was slightly less in the groups receiving the compounds with 30 or 35 micrograms estrogen and the groups receiving the norgestrel compound had no increase in triglycerides and a slight decrease in cholesterol levels. When the CVR was compared with all oral contraceptives it was found to produce no change in angiotensinogen levels and a decrease in triglycerides. Some of each group of OC users had a lowering of antithrombin III to abnormal levels but none of the CVR users had his amount of decrease. As oral steroids with 30 or 35 micrograms of estrogen do not produce significantly less metabolic alteration than do compounds with 50 micrograms of estrogen, it is unlikely that their use will reduce the incidence of the uncommon serious adverse effects associated with OC use. However, since the CVR's did not increase angiotensinogen, their use as contraceptives will most likely not produce hypertension and possibly the other serious circulatory problems which are increased in some OC users.

Transcortin as an indicator of estrogenic potency in oral contraceptives

Serum cortisol-binding globulin (CBG) was measured before, during and following a 21-day application period of 5 oral contraceptives used in the GDR. In a second group of patients determinations were carried out at the end of a 24-month treatment period and the end of the first post-treatment cycle. From a third group of volunteers blood samples were taken at the end of the first, second and third treatment cycles. All the drugs tested produced a marked increase of CBG in serum, reaching its maximum at the end of the second treatment cycle. Within four weeks following termination of application the level fell to the control range. There were no significant differences between the various contraceptives.

Effects of pregnancy and contraceptive steroids on gallbladder function

We used real-time ultrasonography to study gallbladder kinetics in 11 nonpregnant women, 17 women using steroid contraceptives, and 33 pregnant women. Gallbladder volume was determined after an overnight fast and serially for 90 minutes after a standard liquid meal. After the first trimester of pregnancy, gallbladder volume during fasting and residual volume after contraction were twice as large as in control subjects. The rate of emptying and the percentage emptied were reduced. In early pregnancy the only important abnormality was a 30 per cent decrease in emptying rate. Gallbladder function was not affected by contraceptive steroids. Incomplete empyting of the gallbladder in late pregnancy leaves a large residual volume and may cause retention of cholesterol crystals, a prerequisite for cholesterol-gallstone formation. These findings are consistent with the view that pregnancy increases the risk of cholesterol gallstones. The increased incidence of gallstones associated with contraceptive steroids does not involve abnormal gallbladder kinetics.

Steroid 16 alpha-hydroxylase from human fetal liver; inhibition by steroids

The 16 alpha-hydroxylase system in fetal liver which used dehydroepiandrosterone (DHA) or pregnenolone as substrate, was apparently inhibited by various endogenous and synthetic steriods: DHA, pregnenolone, their sulfates, androstenediol, androstenetriol, estrone, estradiol-17 beta, ethynylestradiol and chlormadinone-acetate. The inhibition constants (Ki) towards DHA were as follows; pregnenolone 22 muM, DHA-sulfate 13 muM, pregnenolone-sulfate 21 muM, androstenediol 16 muM, androstenetriol 53 muM estrone 32 muM, estradiol-17 beta 74 muM, ethynylestradiol 22 muM and chlormadinone-acetate 27 muM. The Ki values towards pregnenolone were DHA 6.3 muM, DHA-sulfate 8.3 muM, pregnenolone-sulfate 3.9 muM, androstenediol 8.7 muM, androstenetriol 14.7 muM, estradiol-17 beta 15.4 muM and ethynylestradiol 16.0 muM, respectively. The reaction products, 16 alpha OH-DHA and 16 alpha OH-pregnenolone, showed little inhibitory effect upon the 16 alpha-hydroxylase.

Naphthylamidase isoenzymes in serum during treatment with oral contraceptives

This prospective study of 90 patients after lumbar metrizamide myelography indicates that the semiupright position at 45° in bed or early ambulation reduces postprocedure vomiting but does not reduce the frequency of headache. Ambulatory patients have less frequent nausea than patients kept in bed.

The effect of oral contraceptives on mononuclear cell cholesteryl ester hydrolase activity

The influence of sex steroids on mononuclear cell cholesteryl ester hydrolase (CEH) activity in premenopausal women and women on combined estrogen-progestin oral contraceptives has been studied. In addition, plasma and mononuclear cell cholesterol and esters were measured along with plasma estrogen and progesterone levels. Mononuclear cell CEH activity in control women is highest on Day 20 of their menstrual cycle. The control women had significantly higher CEH activities than women on oral contraceptives. Plasma esters were higher in the oral contraceptive group. However, in mononuclear cells, free cholesterol but not cholesteryl esters were higher in women on oral contraceptives.

Synthesis and estrogenic properties of 17-epi-ethynylestradiol and its ether derivatives epimestranol and epiquinestrol

The synthesis of 17-epi-ethynylestradiol (10), the 17 beta-ethynyl-17 alpha-ol epimer of the well-known orally active estrogen, ethynylestradiol (1), was achieved by LiA1H4 reduction of epoxide 9, as well as by demethylating epimestranol (11) with CH3MgI. Compound 11 was obtained by the unusual 17 beta-ethynylation of estrone 3-methyl ether 22 under equilibrating conditions. The in vitro estrogen receptor-binding affinity and the oral estrogenicity in the rat for the 17-epi compounds 10, 11 and 20 (epiquinestrol) was evaluated. Despite moderate estrogen receptor-binding affinity, compound 10 was devoid of measurable estrogenicity at 10 mg/kg or antiestrogenicity at 3 mg/kg.

Interaction of mestranol with taurocholate uptake by isolated rat hepatocytes

Cellular uptake interactions between mestranol and taurocholate at concentrations between 50 and 1000 microM in the medium were studied in isolated hepatocytes. Rat liver cells exposed to medium containing mestranol and taurocholate attained up to twice as large a concentration of mestranol as those exposed to mestranol without the presence of the bile acid in medium. In contrast, taurocholate concentration in cells exposed simultaneously to taurocholate and mestranol was one fourth of the concentration in cells exposed to taurocholate alone.

The effect of menopausal status and sequential mestranol and norethisterone on serum cholesterol, triglyceride and electrophoretic lipoprotein patterns

The serum cholesterol, triglycerides and electrophoretic lipoprotein patterns of 35 postmenopausal women, who subsequently received sequential mestranol and norethisterone, were compared with those of 35 premenopasual women of the same age and weight. The postmenopausal women had a significantly higher level of serum cholesterol (p less than 0.01) than the premenopausal women, and a significant reduction (p less than 0.001) occurred in this group after two months of therapy. There was no significant difference in level of serum cholesterol between the premenopausal group and the postmenopausal group receiving sequential mestranol and norethisterone for two months. The serum triglycerides were not significantly higher in the postmenopausal group but there was a significant increase (p less than 0.001) after two months of therapy. The marked alteration in lipid levels at the menopause may in part account for the great increase in coronary artery disease in postmenopausal women but whether these changes are reversible by giving hormone therapy remains speculative.

Plasma levels of adrenocorticotropin and cortisol in women receiving oral contraceptive steroid treatment

The secretion rate and plasma concentration of the adrenocortical steroid cortisol is modified in subjects treated with estrogenic and/or progestational steroids. The effects of contraceptive steroids on the secretion of ACTH are poorly documented, however, In the current investigation, we found that concentrations of ACTH and cortisol in plasma obtained at 0800--0900 h from a group of women with normal cyclic menses (n = 4) ranged from 78--120 pg/ml and 77--137 ng/ml, respectively. Although significant cyclic changes in the plasma levels of LH, FSH, 17 beta-estradiol, and progesterone occurred during the ovarian cycle, no obvious cyclic fluctuations in plasma levels of ACTH or cortisol were observed. In women treated with Norinyl 1 + 80 (1.0 mg norethindrone plus 0.08 mg mestranol), plasma concentrations of LH, FSH, 17 beta-estradiol, and progesterone were significantly lower (P less than 0.001) than plasma levels of these hormones in normal women during the ovarian cycle. The mean daily plasma concentrations of ACTH were significantly lower (P less than 0.001), whereas plasma cortisol levels were significantly higher (P less than 0.001) in women treated with oral contraceptive steroids compared to the levels of these hormones in the untreated ovulatory women.

A randomized double blind study of two oral contraceptives

To study the question of whether one brand of oral contraceptives may be as acceptable as another for use of publicly-assisted family planning programs, a double blind study of two well-known brands, Ovral and Norinyl, was undertaken in Costa Rica and Trinidad. The pills were randomly assigned to 1,200 women. Common side effects - nausea, dizziness, vomiting, headaches - were associated with both Norinyl and Ovral. Differences in event rates for these conditions were much more marked by country than by the pill used. Ovral was associated with increases in skin problems, notably chloasma, in Cost Rica. A higher percentage of women using Norinyl reported intermenstrual bleeding and spotting in both countries. In Costa Rica continuation rates for Norinyl were adversely affected by this. With these exceptions there appear to be no important differences between the brands that would affect their use in family planning programs.

Studies on liver function under the influence of oral contraceptives

The effects of two sequential therapies using mestranol as an estrogen and chlormadinone acetate and norethisterone acetate, respectively, as a gestagen on the aminotransferase (GOT and GPT), alkaline phosphatase and alpha-amylase activities, the cholesterol, total bilirubin and total protein contents and the indocyanine green (Ujoviridin, VEB Chemiekombinat Bitterfeld) half-life were studied in two groups, each comprising 12 women of fertile age. The serum protein was separated by paper electrophoresis and both the thymol turbidity and zinc sulphate tests were performed during the first treatment cycle. An estrogen-induced rise in alanine aminotransferase (GPT) activity from 6.31 U/liter to 12.14 U/liter was observed during application of the mestranol/chlormadinone acetate therapy. The value dropped to 5.34 U/liter when chlormadinone acetate was administered as a gestagen in addition to the estrogen. No significant changes were noted in the other biochemical parameters. Sequential therapy involving application of mestranol and norethisterone acetate produced only statistically secured rises in the alpha 1-globulin content and the GPT activity. All other changes in the different parameters remained within the normal range and were statistically insignificant.

Effects of oral contraceptives on zinc and copper levels in human plasma and endometrium during the menstrual cycle

Effects of Ovulen-21, Demulen, Enovid-E and Ovral on zinc and copper levels in human plasma and endometrium during the menstrual cycle have been studied. Both plasma and endometrium copper levels were significantly elevated above the control values (P less than 0.001) in women taking oral contraceptives while the zinc levels remained reasonable constant.

The effect of oral contraceptives on the gonadotropin response to LHRH

This study was designed to assess the effect of long-term treatment with three combined oral contraceptives (OC) on the gonadotropin response to LHRH. The release of LH and FSH after a single 50-microgram dose of LHRH was studied from Days 11 to 14 of treatment and Days 2 and 3 after discontinuation of the treatment. The responses were compared with controls during the luteal phase (Days 16 to 19) of the menstrual cycle. LH and FSH baseline levels and release after LHRH injection were markedly depressed in women on OC treatment. The patterns of gonadotropin response after LHRH, however, were similar to the responses during the luteal phase. Following discontinuation of OC treatment, the basal levels of LH and FSH and the response to LHRH continued to be depressed, with a further decrease in the FSH release. These results indicate that treatment with combined OC exert a significant depression on the release of gonadotropins.

Prolactin and the development and progression of early neoplastic mammary gland lesions

Chronic suppression of prolactin by 2-bromo-alpha-ergocryptine (CB-154) in young nulliparous or mature multiparous C3H mice sharply suppressed the development of preneoplastic mammary gland lesions (hyperplastic alveolar nodules) and markedly inhibited the progression of these preneoplasias to carcinomas. This effect was also observed in C3H mice treated with either 17beta-estradiol or the oral contraceptive Enovid. Chronic CB-154 induced prolactin suppression was more effective than ovariectomy in the suppression of hyperplastic alveolar nodule development and comparable to ovariectomy in the suppression of mammary carcinoma development. Evidence is also provided indicating that human placental lactogen, a peptide chemically and physiologically similar to prolactin, promotes growth both in vitro (organ culture) and in vivo (athymic "nude" mouse) of the epithelium contained in benign human breast tumors. Whether or not human pituitary prolactin is capable of mimicking the mammotrophic action of human placental lactogen and whether a dysplastic, prolactin-sensitive lesion comparable to hyperplastic alveolar nodules exists in the human breast remains to be determined.

Comparative studies of the ethynyl estrogens used in oral contraceptives. VII. Effects with and without progestational agents on ultracentrifugally fractionated plasma lipoproteins in humans, baboons, and beagles

Ethynyestradiol and mestranol, in doses ranging from 50 to 100 microgram/day, were given to women in 21-day cycles; baboons and beagle dogs received 1 and 4 microgram/kg/day in a similar regimen. After a number of such cycles, megestrol acetate, norethindrone acetate, or dl-norgestrel was given concomitantly. Protein, cholesterol, triglyceride, and phospholipid levels were determined in total plasma and in ultracentrifugally separated lipoprotein fractions. Over the dosage range studied, the effects of the two kinds of estrogen were indistinguishable. Except for human total plasma triglyceride, no dose-related differences were observed. The lowering of serum protein and the increase in cholesterol induced by estrogen were more pronounced in baboons and beagles than in human subjects. The cholesterol-depressing effect of progestational compounds observed in humans was very pronounced in baboons but absent in beagles. In all three species, estrogen increased the lipoprotein fraction cholesterol, except for human low-density lipoprotein cholesterol, which was decreased. Human plasma triglyceride and phospholipid increased on estrogen administration and were decreased by the progestins; in the two animal species, triglyceride is normally very low and the estrogen-induced changes were negligible; the phospholipid rose with estrogen but was unaffected by progestins. In sum, the two animal species show many similarities to, as well as important differences from, the human response of plasma lipids to various contraceptive steroids.

The effect of oral contraceptive treatment on the serum concentration of dehydroisoandrosterone sulfate

Dehydroisoandrosterone sulfate (DS), the major C19-steroid in the human circulation, was measured in serum obtained from blood samples collected daily (8 to 10 A.M.) throughout the menstrual cycles of eight normal, presumably ovulatory women and daily throughout the treatment cycles in four women taking an oral contraceptive (norethindrone, 1 mg., plus mestranol, 80 mcg.). The serum concentrations of DS in the ovulatory women ranged from 1,025 to 4,200 ng. per milliliter; mean, 2,062 +/- 137 ng. per milliliter (mean and standard error; n = 213). Serum DS concentrations during the follicular and luteal phases of the menstrual cycles of these women were similar. In women taking the oral contraceptive, the plasma DS concentrations ranged from 475 to 1,400 ng. per milliliter (mean, 895 +/- 83; n = 119). The 24 hour secretory pattern of DS was evaluated in one subject during a nontreatment cycle and again after 20 days of oral contraceptive treatment. In this subject, the mean serum DS level was 34 per cent lower during oral contraceptive treatment than the level before treatment. The decrease in the serum concentration of DS during oral contraceptive treatment likely results from a reduction in adrenal DS secretion since DS secretion by the normal human ovary is negligible and ovarian dehydroisoandrosterone secretion is small. Therefore, it is likely that the reduced serum DS levels in women taking oral contraceptives are the consequence of reduced adrenal secretion of DS resulting from reduced release of adrenocorticotropic hormone.

Oral contraceptive estrogen and plasma lipid levels

Blood samples were obtained from 20 women, aged 18 to 30 years, before and during the use of selected oral contraceptives. The contraceptive preparation containing 100 microgram mestranol induced increases in triglycerides, esterified cholesterol, free cholesterol, and phospholipids. Ethinyl estradiol with norgestrol, on the other hand, tended to decrease the lipid levels, while preparations containing only 50 microgram mestranol produced no significant change in the levels of the four substances. The levels produced by each of these three preparations did not exceed the normal limits. A cyclic fluctuation was observed in the monthly cycles.

[Effect of an estrogen-progestin contraceptive preparation on the enzymatic acitivity of the pentosephosphate carbohydrate metabolic pathway and nucleic acid metabolic indices]

The effect of a long-term (14 days) combined introduction of mestranol and noiethinodrel in contraceptive doses on the activity of pentosophosphate routes enzymes of the carbohydrates metabolism, that of acid and basic ribonucleases and on the level of summary nucleinic acids in the uterus and liver in sexually mature female-rats was studied. It was found that the concentration of summary nucleinic acids in the tissues increases under the effect of the drug, the oxidative reactions enzymes become more active, while the activity of non-oxidative reactions enzymes of the pentosophosphate route and of acid and basic endoribonucleases in inhibited.

Comparative studies of the ethynyl estrogens used in oral contraceptives. VI. Effects with and without progestational agents on carbohydrate metabolism in humans, baboons, and beagles

Human subjects, baboons, and beagles were given cyclic regimens of ethynylestradiol or mestranol; after a number of such cycles, concurrent administration of norethindrone acetate, dl-norgestrel, or megestrol acetate was introduced for a similar number of cycles. Carbohydrate tolerance was evaluated by oral glucose tolerance testing in the human subjects and by intravenous glucose tolerance testing in the baboons and beagles. In the human subjects, neither mestranol nor ethynylestradiol at daily doses of 50 to 100 microgram/day produced any effect on fasting glucose levels or on glucose tolerance even after six cycles of treatment. The addition of the progestational compounds also had no effect on these two variables. In baboons, ethynylestradiol and mestranol were bioequivalent and produced a dose-related decrease in the glucose disposal rate. All three progestational agents counteracted this effect in a comparable manner. In beagles, on the other hand, estrogens produced an increase in the glucose disposal rate, and the addition of progestational agents produced an initial fall and a subsequent return to pretreatment levels.

The effects on sexual response and mood after sterilization of women taking long-term oral contraception: results of a double-blind cross-over study

Twenty women using oral contraception for a minimum of 2 years with no side effects volunteered to take part in this experiment which commenced after they had undergone laparoscopic sterilization. In a double-blind cross-over design, patients were administered either 1.0 mg ethynodiol diacetate + 0.1 mg mestranol ("Ovulen") each day for 21 days or an identical-looking placebo for the same number of days. The following month the alternative (cross-over) tablet was given. On days 12 and 25 of each cycle the women completed a modified form of Pitt's Depression Index and a short Sexual Response Score. The result indicated that the active pill ("Ovulen") was associated with a decreased sexual response, but with no increase in the depression index (relative to placebo). The significance of these findings is discussed in relation to previous work, the methodology of the study and hormone-behaviour experiments.

Morphological effects of estrogen on the female rat liver nucleolus

Prolonged administration of nonphysiological amounts of estrogen induced markedly enlarged nucleoli volumes in rat hepatocytes, indicative of increased nucleolar RNA synthesis. Physiological amounts of drug had no apparent morphological effects on the hepatocytes.

Effect of oral alanine loads on plasma amino acids in oral contraceptive users and control women

Plasma amino acids were determined before and after orally administered alanine loads in five women using an estrogen-containing oral contraceptive and four healthy female controls. Oral contraceptive users and significant reductions in fasting plasma valine, methionine, isoleucine, tyrosine, phenylalanine, histidine, glutamic acid, and alpha-aminobutyric acid. With the exception of alpha-aminobutyric acid, these differences between the two groups were eliminated within 3 hr of alanine ingestion. This effect was due to a gradual increase in the plasma amino acids of the oral contraceptive-treated women, plus no change or slight reductions in the controls.

[Determination of antithrombin III (chromogenic substrates) and FDP in women in treatment with oral estroprogestin agents]

In 280 women, in fertile age, 133 of whom represented the control group, FDP and antithrombin III with the method of chromogenic substrates were determined. In 147 women, who were taking, for variable period of time, oral estroprogestinic drugs, a significant diminution of antithrombin III was found. No significant differences for FDP were observed.

Comparative studies of the ethynyl estrogens used in oral contraceptives: effects with and without progestational agents on plasma androstenedione, testosterone, and testosterone binding in humans, baboons, and beagles

The effects of ethynylestradiol or mestranol given in cyclic fashion, with and without a progestational compound (norethindrone acetate, dl-norgestrel, or megestrol acetate), on plasma androgens and their binding were examined in adult women, female baboons, and beagles. The two estrogens are equivalent in their effect, and there were essentially no dose-related differences over the range examined. In human subjects, the estrogens increased total testosterone and testosterone binding, and decreased free testosterone. In baboons, estrogen produced a transient decrease in total testosterone and an increase in binding. The levels of progestational agents used did not affect total testosterone in humans, as is commonly observed with commercial agents, but did decrease it in baboons. Percentage binding was decreased in both species by the 19-nor compounds, but not by megestrol. Androstenedione levels were unaffected in human subjects, but effects of both estrogens and progestins were seen in baboons. Because of the very low levels of androgens in female beagles, this species did not lend itself well to a study of this kind. However, an increase in testosterone binding was induced by estrogen even in the absence of testosterone/estrogen-binding globulin.

[Modulation of the pituitary response to LH-RH by synthetic sex steroids (author's transl)]

This study was planned in order to investigate the response of the pituitary gonadotropin secretion to the luteinizing hormone-releasing hormone (LH-RH) in each menstrual phase (early follicular, late follicular, luteal) of women with regular menstrual cycles, and the effect of synthetic sex steroids on the response of the pituitary to LH-RH, as compared with the response in the late follicular phase. A dose of 200microgram of LH-RH was administered intramuscularly in the early follicular, and luteal phase of regular menstrual cycles. Three groups of 35 normal women administered 3 kinds of sex steroids were also examined on the 8th to 10th day after medication, except for a long-term administration group of norethindrone. The first group was a mestranol group with two subgroups given a daily administration of 20microgram and 40microgram. The second was a norethindrone group, in which one was a short-term group given a daily administration of 5mg, and another was a long-term group given a daily administration of 10mg to 20mg for more than 150 days. The third was a chlormadinone acetate group given a daily administration of 2mg. Blood samples were obtained before the injection of LH-RH at 15, 30, 60, 90, 120, 180 minutes and 24 hours after the injection. Their sera were separated and frozen at -20 degrees C until assayed. Serum LH and FSH concentrations in each experimental group were used as the standard preparation and expressed as mIU/ml of serum. The results were as follows: 1) Serum LH and FSH responsiveness to LH-RH in women with regular menstrual cycles were greater with regard to late folicular, luteal and early follicular phases, respectively, except for a percent increase of serum LH. 2) The serum LH level in response to the LH-RH injection in the early follicular and luteal phases of the cycle showed a biphasic pattern of elevation characterized by the first pool, releasable LH; and the second pool, newly synthesized and stored LH in the pituitary. The biphasic pattern of serum FSH was not confirmed in this experiment. 3) Sham disappearance of biphasic pattern of serum LH release in the late follicular phase was attributed to a shifting of LH form the 2nd pool to the 1st pool due to an increase of the endogenous estrogen. 4) The capacity of the pituitary FSH synthesis and storage showed a slight increase in the late follicular phase, which was supposed to be enhanced by estrogen. 5) The serum LH peak in the mestranol group was observed at 120 minutes after the LH-RH injection, which was significantly elevated in the group given a daily administration of 40microgram, as compared with the control group. The LH concentration occupied in a definite volume tended to be reduced in the first pool after the LH-RH injection in the mestranol group and didnt change in the second pool after the injection, as compared with the control group...

Influence of 3-methylether of ethinylestradiol (Mestranol) on oviductal egg transport in rats

The development of fertilized eggs and their transport through the oviduct were studied in rats treated orally with 3-methylether of ethinylestradiol (mestranol) at a single administration in different doses. The ED50 values were in the same range (0.11--0.34 mg mestranol/kg b.w.) as well in postcoital pregnancy inhibition test as in the experiments on tubal egg contents on day 3 as in implantation sites in niagara blue test on day 6. This suggests that the uniform cause of pregnancy inhibition of postcoital mestranol treatment on day 1 in rats is the acceleration of tubal egg transport. The ED50 of mestranol given on day 1 shortened the stay of eggs in tubes to 24 hours. Mestranol dosage above the ED50 reduced the tubal stay towards two days in comparison to five days in control animals. The number of eggs prematurely expelled from the tubes into the uterus was relatively high on day 2 and 3 in animals treated with mestranol in high dosage and with ligated cervix, compared with animals without ligation. But on day 4 on blastocysts were found. This result shows that the prevention of pregnancy is caused by the expulsion of blastocysts from uterus and/or the degeneration of zygotes in utero. Blastocysts or morulae recovered from treated rats in high dosage were transferred to the uteri of pseudopregnant recipients: 29% developed into normal term foetuses compared to 29 or 30% for both untreated control groups.