Postgraduate Medicine
ISSN: 0032-5481 (Print) 1941-9260 (Online) Journal homepage: http://www.tandfonline.com/loi/ipgm20
Update on Problems of Oral Contraceptives Jack A. Pritchard To cite this article: Jack A. Pritchard (1975) Update on Problems of Oral Contraceptives, Postgraduate Medicine, 57:3, 167-168, DOI: 10.1080/00325481.1975.11713996 To link to this article: http://dx.doi.org/10.1080/00325481.1975.11713996
Published online: 07 Jul 2016.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ipgm20 Download by: [Australian Catholic University]
Date: 24 August 2017, At: 13:06
Abstract UPDATE ON PROBLEMS OF ORAL
. . -. JACK A.C::::::E:;IV~: ®
Downloaded by [Australian Catholic University] at 13:06 24 August 2017
University of Texas Southwestern Medical School at Dallas
The combined estrogen-progestogen oral contraceptives are the most effective reversible contraceptives available. The most frequently prescribed are the combination pills delivering a relatively low dosage of estrogen. S)lggested complications associated with use of oral contraceptives include neoplasms, endocrine changes, weight gain, malnutrition, hypertension, and thromboembolic phenomena. Most data indicate that use of the combination oral contraceptives does not increase the risk of benign or malignant lesions of the breast or malignant lesions of the cervix. Patients taking the pill should be screened annually for cancer of the cervix, and periodic breast examination is indicated, as in all women. Oral contraceptives elevate thyroxine-binding globulin levels, suggesting thyroid malfunction, but the free thyroxine level remains unchanged. This change is not significant and does not indicate thyroid disease. Anovulation is sometimes a side effect of oral contraceptive use, but the incidence is no higher than that following pregnancy. After use of the contraceptive is stopped, ovulation usually resumes spontaneously in a few months, as in pregnancy. In the few instances in which anovulation persists, clomiphene citrate (Clomid) may be used if the woman desires pregnancy. It has some undesirable effects but usually restores ovulation. Progestogen has an anabolic effect and increases appetite and the tendency to gain weight. This gain is not usually due to fluid but is the result of an increase in fat tissue, and perhaps to some extent, muscle. (Continued on page 168) Abstracted from a presentation before the 59th annual assembly of the Interstate Postgraduate Medical Association at Hollywood, Florida.
Vol. 57 • No. 3 • March 1975 • POSTGRADUATE MEDICINE
JACK A. PRITCHARD
Downloaded by [Australian Catholic University] at 13:06 24 August 2017
Dr. Pritchard is Gillette professor of obstetrics and gynecology, University of Texas Southwestern Medical School at Dallas.
Nutritional supplementation does not seem to be necessary for women taking oral contraceptives. Folate deficiency, once believed to cause many pregnancy complications, does not appear to be a major concern. The pill actually has a beneficial effect on iron metabolism, since it decreases menstrual blood loss, and thus, iron loss. The women who ordinarily might lose about 2 pt of blood per year would while taking the pill most likely lose about 1 pt or even less. Oral contraceptives are associated with a slight, but real, increase in the risk of deep venous thrombosis_ and thromboembolism. They are contraindicated in persons who have had these lesions or those with obvious venous incompetence or venous vascular disease. While in use, they may infrequently cause an increase in blood pressure and thus are contraindicated in hypertensive patients. All women taking the pill should have blood pressure measurements periodically, and if hypertension develops, use of the pill should be stopped. The young woman who has had preeclampsia or eclampsia and who subsequently becomes normotensive does not appear to be at unusual risk from use of an oral contraceptive. Increased chromosomal breakage and a shortlimb syndrome have been reported in offspring of women who have used oral contraceptives, but these disorders appear to be quite rare and not of concern in most pregnancies. If a woman has had a malformed child and plans a future pregnancy, perhaps the pill should not be used. In general, oral contraceptives may be used by healthy women but should not be prescribed for women with preexisting systemic disease. Oral contraceptives should be used for spacing pregnancies, but once the family is complete, permanent sterilization of one of the partners should be strongly considered.
168
llosone®
(erythromycin estolate)
W•mlng Hepatic dysfunction with or without jaundice has occurred,chiefly in adults, in association with erythromycin estolate administration. it may be accompanied by malaise, nausea, vomiting, abdominal colic, and fever. In some instances, severe abdominal pain may simulate an abdominal surgical emergency. If the above findings occur, discontinue llosone promptly. llosone is contraindicated for patients with a known history of sensitivity to this drug and for those with preexisting liver disease. lndiCIIIIDnl: Streptococcus pyogenes (Group A Beta-Hemolytic)-Upper and lower-respiratory-tract, skin, and soft-tissue infections of mild ·to moderate severity. Injectable benzathine penicillin G is considered by the American Heart Association to be the drug ot choice in the treatment and prevention of streptococcal pharyngitis and in long-term prophylaxis of rheumatic lever. When oral medication is preferred .for treating streptococcal pharyngitis, penicillin G or V or erythromycin is the alternate drug of choice. The importan
ISSN: 0032-5481 (Print) 1941-9260 (Online) Journal homepage: http://www.tandfonline.com/loi/ipgm20
Update on Problems of Oral Contraceptives Jack A. Pritchard To cite this article: Jack A. Pritchard (1975) Update on Problems of Oral Contraceptives, Postgraduate Medicine, 57:3, 167-168, DOI: 10.1080/00325481.1975.11713996 To link to this article: http://dx.doi.org/10.1080/00325481.1975.11713996
Published online: 07 Jul 2016.
Submit your article to this journal
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ipgm20 Download by: [Australian Catholic University]
Date: 24 August 2017, At: 13:06
Abstract UPDATE ON PROBLEMS OF ORAL
. . -. JACK A.C::::::E:;IV~: ®
Downloaded by [Australian Catholic University] at 13:06 24 August 2017
University of Texas Southwestern Medical School at Dallas
The combined estrogen-progestogen oral contraceptives are the most effective reversible contraceptives available. The most frequently prescribed are the combination pills delivering a relatively low dosage of estrogen. S)lggested complications associated with use of oral contraceptives include neoplasms, endocrine changes, weight gain, malnutrition, hypertension, and thromboembolic phenomena. Most data indicate that use of the combination oral contraceptives does not increase the risk of benign or malignant lesions of the breast or malignant lesions of the cervix. Patients taking the pill should be screened annually for cancer of the cervix, and periodic breast examination is indicated, as in all women. Oral contraceptives elevate thyroxine-binding globulin levels, suggesting thyroid malfunction, but the free thyroxine level remains unchanged. This change is not significant and does not indicate thyroid disease. Anovulation is sometimes a side effect of oral contraceptive use, but the incidence is no higher than that following pregnancy. After use of the contraceptive is stopped, ovulation usually resumes spontaneously in a few months, as in pregnancy. In the few instances in which anovulation persists, clomiphene citrate (Clomid) may be used if the woman desires pregnancy. It has some undesirable effects but usually restores ovulation. Progestogen has an anabolic effect and increases appetite and the tendency to gain weight. This gain is not usually due to fluid but is the result of an increase in fat tissue, and perhaps to some extent, muscle. (Continued on page 168) Abstracted from a presentation before the 59th annual assembly of the Interstate Postgraduate Medical Association at Hollywood, Florida.
Vol. 57 • No. 3 • March 1975 • POSTGRADUATE MEDICINE
JACK A. PRITCHARD
Downloaded by [Australian Catholic University] at 13:06 24 August 2017
Dr. Pritchard is Gillette professor of obstetrics and gynecology, University of Texas Southwestern Medical School at Dallas.
Nutritional supplementation does not seem to be necessary for women taking oral contraceptives. Folate deficiency, once believed to cause many pregnancy complications, does not appear to be a major concern. The pill actually has a beneficial effect on iron metabolism, since it decreases menstrual blood loss, and thus, iron loss. The women who ordinarily might lose about 2 pt of blood per year would while taking the pill most likely lose about 1 pt or even less. Oral contraceptives are associated with a slight, but real, increase in the risk of deep venous thrombosis_ and thromboembolism. They are contraindicated in persons who have had these lesions or those with obvious venous incompetence or venous vascular disease. While in use, they may infrequently cause an increase in blood pressure and thus are contraindicated in hypertensive patients. All women taking the pill should have blood pressure measurements periodically, and if hypertension develops, use of the pill should be stopped. The young woman who has had preeclampsia or eclampsia and who subsequently becomes normotensive does not appear to be at unusual risk from use of an oral contraceptive. Increased chromosomal breakage and a shortlimb syndrome have been reported in offspring of women who have used oral contraceptives, but these disorders appear to be quite rare and not of concern in most pregnancies. If a woman has had a malformed child and plans a future pregnancy, perhaps the pill should not be used. In general, oral contraceptives may be used by healthy women but should not be prescribed for women with preexisting systemic disease. Oral contraceptives should be used for spacing pregnancies, but once the family is complete, permanent sterilization of one of the partners should be strongly considered.
168
llosone®
(erythromycin estolate)
W•mlng Hepatic dysfunction with or without jaundice has occurred,chiefly in adults, in association with erythromycin estolate administration. it may be accompanied by malaise, nausea, vomiting, abdominal colic, and fever. In some instances, severe abdominal pain may simulate an abdominal surgical emergency. If the above findings occur, discontinue llosone promptly. llosone is contraindicated for patients with a known history of sensitivity to this drug and for those with preexisting liver disease. lndiCIIIIDnl: Streptococcus pyogenes (Group A Beta-Hemolytic)-Upper and lower-respiratory-tract, skin, and soft-tissue infections of mild ·to moderate severity. Injectable benzathine penicillin G is considered by the American Heart Association to be the drug ot choice in the treatment and prevention of streptococcal pharyngitis and in long-term prophylaxis of rheumatic lever. When oral medication is preferred .for treating streptococcal pharyngitis, penicillin G or V or erythromycin is the alternate drug of choice. The importan
