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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