Gastrointestinal disease and oral contraception
Article Abstract:
Oral contraceptives have been used widely for over 20 years, and their effects in healthy women have been relatively well studied. However, alterations in tissue handling of the steroids (estrogens and progesterones) contained in contraceptives during disease states are not well understood. Besides considering the effects of long-term steroid use on gastrointestinal function, the effects of nutritional influences, gastrointestinal disorders, and interactions with other drugs on absorption of oral contraceptives should be researched. This is particularly important because the dosages of each steroid in contraceptives have gradually been reduced to minimize side effects, and the contraceptive effect may then become more vulnerable to influences of gastrointestinal function and steroid absorption. These issues are reviewed in this article. The metabolism of estrogens and progesterones by the intestinal wall or liver is described. Although antibiotics, which alter intestinal bacteria, and antacids have the potential to affect absorption and handling of the steroids, little evidence exists to support any such effect in patients. Oral contraceptive use may be associated with ulcerative colitis, and possibly Crohn's disease, but the underlying mechanism, if any, is unclear. A probability of contraceptive failure following diarrhea or ileostomy has been postulated, due to increased intestinal removal of contents or decreased available absorptive surface, respectively. Studies of patients with ileostomies or with jejunoileal bypass (used to treat severe obesity) have found a decreased availability of estrogen or progesterone. These results indicate that conditions such as these, which affect small intestinal absorption, would interfere with contraceptive absorption, whereas diarrhea, which typically involves the large intestine, should have no effect. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1990
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Hemostatic effects of smoking and oral contraceptive use
Article Abstract:
Oral contraceptives can increase the formation of blood clots, and smokers have an even higher risk of abnormal blood clotting. For this reason, smokers should use third-generation oral contraceptives, which have the lowest doses of estrogen.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1999
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