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  • Title: Oral steroidal contraception: scientific basis and recent development.
    Author: Sinnathuray TA.
    Journal: Malays J Reprod Health; 1988 Dec; 6(2):70-82. PubMed ID: 12342171.
    Abstract:
    Modern medicine 1st made the oral contraceptive (OC), a combined OC, available to women in 1960, and much progress in improving OCs and reducing risks associated with them has occurred. Approximately 200 million women have used OCs worldwide and about 60 million women are currently using this contraceptive method. OCs are efficacious because the hormones in the OCs alter the physiology of the hypothalamo-pituitary-ovarian/uterine axis at 6 sites, e.g., altering the endometrium so implantation of the blastocyst cannot occur. Despite the effectiveness of OCs (virtually 100% effective) in comparison with other contraceptive methods, they often cause side effects and complications. Some side effects and complications from estrogen and predominantly estrogen OCs include vomiting, hypertension, and venous thrombosis/pulmonary embolism. Possible progestogen and predominatly progestogen OC side effects and complications are leucorrhea, urinary tract infections, epilepsy aggravation, and cholestatic jaundice. In addition, pregnancy, venous thromboembolism, heart disease, and malignancies of the breast and genital tract are absolute contraindications to OCs. On the other hand, OCs provide health benefits, in addition to preventing unwanted pregnancies, such as lowered incidence of pelvic inflammatory disease, acne improvement, and protection against endometrial carcinoma and ovarian epithelial neoplasia. In order to ensure that health benefits of OCs are maximized and the risks minimized, family planning practitioners worldwide must monitor OC users for side effects. Recent OC formulations now include the progestogen only OCs, multiphase OCs, low dose OC called gestodene, and the "morning after pill".
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