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8. Oral ContraceptivesThere are two major categories of oral contraceptives. They are combination and progestogen only. The combination types contain both a synthetic estrogen and a synthetic progestogen and are given continuously for three weeks. No medication is given for the fourth week to allow for "withdrawal bleeding." Progestogen alone is given in small doses every day but this form of oral contraceptive is not used frequently due to its more severe consequences. 8.1 General EffectsMany effects such as nausea, breast tenderness, fluid retention and depression are related to the dose of synthetic estrogen. Progestogens result in weight gain, acne and nervousness. In addition to effects on the female genital tract, the metabolic activities of synthetic hormonal components of oral contraceptives affect nearly every other organ system of the body. During lactation the amount of milk produced is diminished, and the concentration of protein and fat in the milk is reduced; also, measurable amounts of the hormonal compounds can be found in the milk. You can see why it is especially dangerous to take these substances while lactating. It would have severe adverse effects upon the infant. Serum protein changes occur while taking the pill. Serum copper and iron levels are increased, while tests of thyroid function are altered to the same extent that occurs in pregnancy; e.g., thyroxine-binding globulin capacity increases, while free thyroxine remains normal. In some individuals, deep vein thrombophlebitis and thromboembolism occur. Thrombus formation appears to be related to increases in blood clotting factors, an increase in the number of platelets, and increased platelet adhesion. These changes are the result of the estrogenic component, and the increased incidence of thromboembolism is related to the amount of estrogen given. Central nervous system effects of oral contraceptives include stroke, nausea and vomiting, headache and depression. The incidence of stroke is three times greater in oral contraceptive users than in nonusers. Alterations in glucose metabolism have also been associated with oral contraceptives. Serum levels of some vitamins, trace elements, and lipids may be altered by these drugs. Levels of pyridoxine and folic acid and most other vitamins, as well as ascorbic acid, calcium, manganese, and zinc, are decreased, while vitamin A levels are increased. Serum lipid levels, mainly triglycerides, are elevated in nearly all oral contraceptive users, and cholesterol concentration is increased in many. Studies have proven hat this increase in triglycerides is a direct result of the synthetic estrogen. Discoloration of the skin occurs in some women indicating that the body is trying to discharge this drug via that route. Concerning the dangers of the pill, Dr. Mendelsohn says,
Home > Lesson 78 - Reproductive Problems Of Men And Woman
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