These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Oral contraception: advantages of estrogen reduction].
    Author: Cohen J.
    Journal: Contracept Fertil Sex (Paris); 1993 Jun; 21(6):489-94. PubMed ID: 12318239.
    Abstract:
    Possible advantages of the reduced estrogen does in the newer combined oral contraceptives (OCs) are assessed by means of retrospective study results and theoretical arguments. A complete analysis of the effects of lower estrogen doses would require double-blind prospective studies. The so-called third generation of progestins (desogestrel, gestodene, and norgestimate) have permitted estrogen doses to be greatly decreased. Some combined OCs now contain only 20 mcg of ethinyl estradiol, compared to 50 or more in the earliest formulations. No longterm studies exist that would allow the efficacy of pills with reduced estrogen doses to be compared to that of higher dose formulations. But data from applications for marketing authorization of the low dose formulations expressed in Pearl indices suggest that their efficacy is no lower than that of older formulations. Few studies have compared clinical tolerance of the low-dose OCs with those having higher estrogen doses. None of the existing studies indicate that clinical tolerance of the third generation OCs is less satisfactory and most suggest that it is similar. Lowering the dose of ethinyl estradiol has a beneficial effect on the ratio of total cholesterol to HDL cholesterol and a smaller but persistent effect on triglycerides. The diabetogenic effect is also lessened with lower estrogen doses. Modifications of hemostasis appear to depend on the ethinyl estradiol dose, and they are less marked with 20 mcg of ethinyl estradiol than with 50 mcg. The risks of venous and arterial accidents appear to be lessened with diminished estrogen doses. Only 2 studies have evaluated the risk of breast cancer as a function of estrogen dose, taking into account the duration of use and the various risk factors for breast cancer. The risk of breast cancer was lower in both studies for OCs with the lowest estrogen doses, but the results should be interpreted with caution. Sample sizes for greater durations of use were very small. 2 recent studies of luteinizing hormone and follicle-stimulating hormone levels among users of low-dose OCs contradict the theoretical argument that low-dose formulations will provide insufficient ovarian inhibition. In individual cases of apparently insufficient antigonadotropic effect, the prescription can be modified. The decrease in estrogen doses appears overall to entail more benefits than disadvantages.
    [Abstract] [Full Text] [Related] [New Search]