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  • Title: Clinical pharmacology of the steroidal oral contraceptives.
    Author: Durand JL, Bressler R.
    Journal: Adv Intern Med; 1979; 24():97-126. PubMed ID: 371370.
    Abstract:
    Clinical pharmacology of the steroidal oral contraceptives (OCs) is reviewed. The review includes: effectiveness and mechanism of action; structure-activity relationship; minor side effects (estrogen excess, estrogen deficiency, progestogen excess, progestogen deficiency, management of minor side effects); major side effects (thromboembolic disease, hypertension, OCs and neoplasia); and selection of an OC (effectiveness, safety, patient acceptability). Over the past 2 decades the steroidal OCs have proved to be among the most effective pharmacologic products ever marketed. OCs have proved to be relatively benign in terms of morbidity and mortality. Because the decision to use OCs is complex, only contraindications to its use have been considered here. Absolute contraindications include: 1) history of cerebrovascular disease, thromboembolic disease, thrombophlebitis, or conditions predisposing to these disorders; 2) active liver disease or impaired liver function; 3) carcinoma of the breast; 4) estrogen-dependent neoplasia; 5) undiagnosed genital bleeding; and 6) pregnancy. Relative contraindications include: 1) women over age 40; 2) migraine headaches; 3) Hypertension; 4) leiomyomata of the uterus; 5) epilepsy; and 6) history of idiopathic jaundice of prepregnancy. There is no firm evidence that OC use results in an increased incidence of benign neoplasms of the liver and breast.
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