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  • Title: Hormonal oral contraceptives, urinary porphyrin excretion and porphyrias.
    Author: Gross U, Honcamp M, Daume E, Frank M, Düsterberg B, Doss MO.
    Journal: Horm Metab Res; 1995 Aug; 27(8):379-83. PubMed ID: 7590628.
    Abstract:
    The influence of hormonal oral contraceptives on the urinary porphyrin excretion of 40 healthy females has been studied. Two different hormonal oral contraceptives (combinations of gestoden or desogestrel, respectively, and ethinylestradiol) were applied for half a year. In each case twenty women received one of these two combinations. Porphyrin precursors delta-aminolevulinic acid and porphobilinogen were normal in all subjects as well as the mean of uroporphyrin and coproporphyrin. One healthy female developed a mild secondary coproporphyrinuria. In this case coproporphyrin isomer I was slightly enhanced and isomer III slightly lowered. Furthermore it could be shown that three females with repeated premenstrual clinical expression of an acute hepatic porphyria (acute intermittent porphyria and hereditary coproporphyria) could be treated successfully with a hormonal oral contraceptive or other exogenous hormones to stabilize the latent, subclinical phase of the disease. At clinics in Marburg and Berlin, Germany, physicians conducted a double-blind study to elucidate the effectiveness of two low-dose hormonal contraceptives on parameters of heme-biosynthesis in urine. After a menstrual cycle without exogenous hormones (cycle 0), 40 healthy women took an oral contraceptive (OC) containing either 75 mcg gestodene and 30 mcg ethinyl estradiol daily (EE2) for 21 days or 150 mcg desogestrel and 30 mcg EE2. They took no hormones for the first seven days of the next cycle. They used the OCs for six cycles. In all cases, porphyrin precursors delta-aminolevulinic acid and porphobilinogen and the mean of uroporphyrin and coproporphyrin fell within normal parameters. Only one woman developed mild secondary porphyrinuria without clinical or pathological significance. The coproporphyrin isomer I was moderately higher than the normal range (17-31% vs. 32% at cycle 0 and 43% at cycle 6) and isomer III was moderately lower (69-83% vs. 68% and 57%, respectively). Three women had repeated premenstrual symptoms of an acute hepatic porphyria (acute intermittent porphyria and hereditary coproporphyria). Treatment with the OCs successfully stabilized the latent phase of premenstrual forms of acute hepatic porphyrias. This study demonstrates that low-dose OCs do not affect urinary porphyrin excretion.
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