Oral contraceptives, development

Sex hormones Around 5 % of women taking estrogen-contaming oral contraceptives develop hypertension (this does not occur with progesterone-only anovulant drugs). Any rise in blood pressure is usually small and reversible on cessation of therapy, but severe hypertensive episodes, including malignant hypertension, may occur... 

In a retrospective chart review of 57 islet transplant recipients, ovarian cysts were found in 31 of 44 premenopausal women and only two of 13 postmenopausal women [69. No woman who used combined oral contraception developed ovarian cysts. Sir-olimns withdrawal was associated with a reduction in cyst size and resolution of cysts in 80% of subjects. 

U. Lachnit-Eixson, Tbe Development of aMew Triphasic Oral Contraceptive, MTP Press, Lancaster, U.K., 1980, p. 23. 

The 1950s and 1960s saw the development of orally active progestins based on the synthesis of steroids that lack the C19-angular methyl substituent (19-norsteroids). The commercial production of these compounds for the regulation of menstmal disorders began in 1957, and for oral contraception in 1960. 

Thus, our attention should shift from the concern of potential adverse effects to the health benefits imparted by hormonal contraceptives. The use of oral contraceptives for at least 12 months reduces the risk of developing endometrial cancer by 50%. Furthermore, the risk of epithelial ovarian cancer in users of oral contraceptives is reduced by 40% compared with that on nonusers. This kind of protection is already seen after as little as 3-6 months of use. Oral contraceptives also decrease the incidence of ovarian cysts and fibrocystic breast disease. They reduce menstrual blood loss and thus the incidence of iron-deficiency anemia. A decreased incidence of pelvic inflammatory disease and ectopic pregnancies has been reported as well as an ameliorating effect on the clinical course of endometriosis. 

The role of antigens derived from dietary intake in the development of IBD is less well defined. There is some speculation that ingestion of large quantities of refined carbohydrates or margarine leads to higher rates of CD. Use of oral contraceptives has been associated with increased development of IBD in some cohort studies, but a strong causal relationship has not been proven.7... 

Historically, the 1950s represented an important time in the control of human fertility. It was during that decade that the first combined oral contraceptives were developed. Shortly after the discovery that the exogenous administration of hormones such as progesterone successfully blocked ovulation, the use of hormonal steroids quickly became the most popular method of contraception worldwide. Specifically, combined oral contraceptives represent the most commonly used reversible form of contraception today and it is estimated that nearly 100 million women worldwide take oral contraceptives.1 Further, in the United States, it is estimated that at some time during their lives, more than 80% of women born since 1945 have used oral... 

When compared with women who have never used oral contraceptives, women who have used oral contraceptives for 4 years or less are 30% less likely to develop ovarian cancer. There is also additional evidence to suggest that the longer the duration of oral contraceptive use, the greater the reduction in the risk of ovarian cancer. Women who have taken oral contraceptives for 5 to 11 years are 60% less likely to develop ovarian cancer, and women who have taken oral contraceptives for more than 12 years are 80% less likely to develop ovarian cancer. As with the reduced risk of endometrial cancer, there is evidence to suggest that the benefit of the reduced risk of ovarian cancer may persist for years following discontinuation of oral contraceptives.10-12... 

Women who use oral contraceptives are less likely to develop benign breast cysts or fibroadenomas.1,8... 

Because oral contraceptives suppress ovarian stimulation, women who take them are less likely to develop ovarian cysts.8... 

Although the use of oral contraceptives is not associated with an increased risk for the development of hepatocellular... 

There appears to be an increased risk for the development of cervical cancer among long-term users of oral contraceptives.1 Whether or not this increase in risk can be attributed directly to the use of oral contraceptives is uncertain, however. Data suggest that oral contraceptive users, on average, tend to have more sexual partners and use condoms less frequently, and as a result, this may increase their susceptibility to becoming infected with human papilloma virus (HPV), a known risk factor for cervical cancer. 

Adverse effects include nausea, weight gain, breast tenderness, and breakthrough bleeding. Oral contraceptives have also been associated with an increased incidence of thromboembolic disease, particularly in women who use tobacco products or have other risk factors for thromboembolism. The development of these complications is significantly reduced when low-dose estrogen formulations of oral contraceptives are used.3... 

The minipiir containing only a progestin, rather than a combination estrogen-progestin oral contraceptive, was developed because progestin alone... 

The medical success of these drugs gave new emphasis to the pharmaceutical industry, which was boosted further by the commencement of industrial-scale penicillin manufacture in the early 1940s. Around this time, many of the current leading pharmaceutical companies (or their forerunners) were founded. Examples include Ciba Geigy, Eli Lilly, Wellcome, Glaxo and Roche. Over the next two to three decades, these companies developed drugs such as tetracyclines, corticosteroids, oral contraceptives, antidepressants and many more. Most of these pharmaceutical substances are manufactured by direct chemical synthesis. 

Since the development of the oral contraceptive steroids in the 1960s, various steroids and procedures have been used. Synthetic steroids are now used since their half-hves in the body are longer than the natural steroids. Combined oestrogen-progesterone contraception involves taking one piU each day which contains a synthetic progestogen plus an oestrogen. The pill is taken for 21 dyas, with a break for... 

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