Hormones

I.               The pill and other hormonal methods.

A.    Hormonal* birthcontrol is the most popular method in North America.

B.    They are also the most effective, however some do have side effects.

C.    They do not protect against STDs and HIV.

D.    Methods include:

1. Oral Contraceptive Pill

2. Progestin-only Pill

3. Injection (Progestin)

4. Implant (Progestin)

E.    Oral contraceptives contain two hormones, a progestin and an estrogen.

F.     These hormones, which are similar to ones produced in your own body, keep the hormone level in your blood above a certain threshold and tells the ovaries not to let any egg cells ripen, in a way, the ovaries are put to rest.

II.             Ethinylestradiol/Progestogen – Female Hormonal Contraception

A.    Pharmacology

1. The contraceptive effect of an estrogen-progestogen combination relies predominantly on the inhibition of the gonadotrophin secretion and thus of the ovulation.

2. The cervical mucus is altered in such a way that sperm cannot penetrate it as easily.

3. Ethinylestradiol is almost always used as an estrogen.

4. Different progestogens are used, in particular levonorgestrel, norethisterone, and the newer desogestrel, gestodene, and norgestimate.

B.    Indications

1. The combination of ethinylestradiol with a progestogen is the most reliable drug for contraception.

2. It is most likely insignificant whether the combination is taken as a fixed mixture (single phase pill) or as a graduated preparation (progestogen dose increased in two to three steps).

3. The following "side effects" of oral contraceptives are considered beneficial: reduction of ovarian and endometrial carcinoma (by 40% each), fewer ectopic pregnancies, risk of salpingitis reduced by 50%, fewer fibrocystic breast alterations, decreased blood loss in menstruation, and an advantageous influence on dysmenorrhea.

4. Advantages and disdvantages have been documented mainly for the older preparations (with levonorgestrel or norethisterone).

5. Specialists nowadays predominantly prefer the newer progestogens (desogestrel, gestodene, norgestimate).

6. The advantages that work in favour of these preparations are the good cycle control, the absence of androgenic effects, and a well balanced effect on the blood lipids.

7. The combination of ethinylestradiol and levonorgestrel is also used in emergencies for postcoital contraception ("the pill after").

C.    Adverse reactions and interactions

1. There is a very small risk of cardiovascular complications (thrombophlebitis, pulmonary embolism, hypertension, cardiac infarction, cerebrovascular seizure) when small doses of an ethinylestradiol-progestogen combination are taken.

2. Smoking women over 35 years of age are most endangered.

3. The risk of breast cancer might be minimally increased in nulliparous women who have been treated with contraceptives over a long period of time and who are 25 years or younger.

4. Cervical alterations and hepatobiliary complications (e.g. liver adenoma) are rare. The newer contraceptives can influence glucose tolerance negatively.

5. Frequent but harmless side effects are nausea, headaches, libido alterations, mental depressions, spotting, weight alterations.

III.            Male hormonal contraception has been developing for 20 years

A.    The contraceptive efficacy of weekly TE injections has been proved to be sufficient (1.3 pregnancies/100 person years, WHO 1996, Fertil. Steril. 65, 821-829)

B.    The contraceptive stops the production of sperm with the hormone desogestrel, which is used in women's birth control pills too.

C.    The pill for men also includes the male sex hormone testosterone, to prevent feminizing effects from desogestrel.

D.    Scottish scientists testing the male pill for Edinburgh University's Centre for Reproductive Biology said they were delighted with the results.

E.    Men's sperm counts dropped to zero and they experienced no side effects such as acne and high blood pressure, which had been problems with previous versions of a male pill.

F.     Safety

1. No serious side effects have been observed

2. Libido changes, 3.7 % weight gain occur

3. Long-term effects on the cardiovascular system and prostate remain to be studied.

4. Also the effects of long-term androgen treatment on the immune system should be studied.

5. The occurrence of sperm antibodies is associated with nearly every pathological condition of the male reproductive tract

6. Can suppression of testosterone synthesis lead to breakdown of the systems protecting from immunisation against sperm?

IV.           Steroids

A.    They are related to testosterone, a male sex hormone.

B.    Anabolic steroids help to rebuild tissues that have become weak because of serious injury or illness.

C.    A diet high in proteins and calories is necessary with anabolic steroid treatment.

D.    Anabolic steroids may also be used for other conditions as determined by your doctor.

E.    Anabolic steroids are available only with your doctor's prescription, in the following dosage forms:

1. Oral

2. Oxandrolone Tablets (U.S.)

3. Oxymetholone Tablets (U.S. and Canada)

4. Stanozolol Tablets (U.S.)

5. Parenteral

6. Nandrolone Injection (U.S. and Canada)

 

 

 

 

 

 

References

 

Ethinylestradiol - Infomed Guide. http://www.infomed.org/100drugs/estrfram.html. 1996. Infomed-Verlags AG.

 

 

Male Birth Control Pill Is 100% Effective. http://prochoice.about.com/library/blstmalepill.htm. 2001. About.com.

 

 

Male Contraceptives.org. http://www.malecontraceptives.org/. 2000. malecontraceptives.org  

 

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