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  • Title: Oral contraceptives and nutrition interaction.
    Author: Bamji MS.
    Journal: Icmr Bull; 1985 Jul; 15(7):85-9. PubMed ID: 12280294.
    Abstract:
    Oral contraceptive agents (OCs) have been a part of the family planning package in India for a number of years, but their acceptability, particularly in low income groups, is quite poor. Clinical trials show a continuation rate over 6 to 12 months of less than 25% to 50%. Recent studies suggest that poor motivation and the inconvenience of having to remember to take a pill daily, rather than biomedical and physiological factors, are the major factors responsible for the discontinuation from OC trials. The interactions between OCs and nutrition are broken down to: 1) the effects of OCs on nutrition status; 2) the effects of malnutrition on some of the well documented and other side effects of OCs; 3) the effects of malnutrition on metabolism of contraceptive steroids and contraceptive efficacy; and 4) a 3 way interaction between malnutrition, disease, and drugs used in the treatment of these diseases. Experiments with rats show that OCs alter the vitamin economy by increasing the cellular requirement for the vitamins by selective increments in specific binding proteins, or apoenzymes, rather than tissue depletion. In a recent special Programme for Research in Human Reproduction (WHO), nutritional status did not appear to have any significant effect on compliance, contination rates, pregnancy rates, prevalence of menstrual side effects, or prevalence of nonspecific symptoms in any of the 3 Indian centers. Overall, data suggest that use of low dose formulations of OCs over a period of 1 year does not significantly alter the existing state of malnutrition in women in developing countries. Although malnutrition does modify the pharmaco-dynamics of contraceptive steroids, the dose of hormones in the contraceptive preparations are adequate to maintain effective blood levels of the hormones. Therefore, OCs can be used by malnourished women for short-term spacing, provided there is adequate education and clinical support to ensure regular tablet taking and for screening women to whom OC use in contraindicated.
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