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  • Title: Factors affecting pituitary gonadotropin function in users of oral contraceptive steroids.
    Author: Scott JA, Brenner PF, Kletzky OA, Mishell DR.
    Journal: Am J Obstet Gynecol; 1978 Apr 01; 130(7):817-21. PubMed ID: 345817.
    Abstract:
    In order to determine whether certain factors influence the direct pituitary suppressive effect of contraceptive steroid, 50 subjects who had used various formulations of oral contraceptive steroids for periods of time ranging from one to nine years were stimulated with 50 microgram of gonadotropin-releasing hormone (GnRH) during the last week of oral contraceptive ingestion. The response of lutinizing hormone (LH) and follicle-stimulating hormone (FSH) was compared to the results obtained in nine control subjects with regard to: (1) age of subject. (2) type of contraceptive formulation used, and (3) length of use. Prestimulation levels of LH and FSH, respectively, were significantly decreased in 37 (74 per cent) and 42 (84 per cent) of the subjects. Following GnRH stimulation, peak responses of serum LH and FSH, respectively, were also significantly lower than those in the control subjects in 40 (80 per cent) and 45 (90 per cent of the subjects. The degree of suppression of pituitary gonadotropins, both before and after GnRH administration was significantly correlated with the type of steroid formulation used, being greatest with a combination of d-norgestrel and ethinyl estradiol. No correlation was found with length of use of oral contraceptives or age of the subjects. 50 subjects using various formulations of oral contraceptives (OCs) for periods ranging from 1-9 years were stimulated with 50 mcg of gonadotropin-releasing hormone (GRH) during the last week of OC ingestion to determine whether certain factors influence the direct pituitary suppressive effect of OCs. Response to luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was compared with results from 9 controls with regard to: 1) age, 2) OC formulation, and 3) length of OC use. Prestimulation levels of LH and FSH, respectively, were significantly decreased in 37 (74%) and 42 (84%) subjects. After GRH stimulation, peak responses of serum LH and FSH, respectively, were also significantly lower than those in controls in 40 (80%) and 45 (90%) subjects. Degree of suppression of pituitary gonadotropins, both before and after GRH administration, was significantly correlated with steroid formulation used. Results indicate that: 1) combined OCs have a direct suppressive effect on pituitary gonadotropins; 2) the ethinyl estradiol and norgestrel formulation produces a more profound suppressive effect on pituitary gonadotropins release than those containing mestranol and nonethindrone; and 3) there is no correlation between age of subject or length of OC use and the degree of pituitary gonadotropins inhibition.
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