Benefits and Risks of Hormonal Contraception: Has the Attitude Changed?

ISBN-13: 9789401166775 / Angielski / Miękka / 2012 / 192 str.

A. A. Haspels; R. Rolland

Opis

A. A. Haspe/s It is with pleasure that I welcome you, on behalf of Professor Rolland and myself, to Amsterdam for this International Symposium on 'Benefits and Risks of Hormonal Contraception'. As a means offamily planning the pill is about 25 years old - a timespan which has been characterized by an enormous increase in public interest and concern with family health and family-planning. Undoubtedly we have learned a lot over the last 25 years. As you see in Figure 1, in the seventies in Holland relatively more fertile women used the pill than in any other country in the world. In 1974 new combination pills were introduced containing less than 50 JAg of ethinyl estradiol. In 1981 50 % of Dutch pill- users took a sub-50 (Figure 2). The same is true for the Scandi- navian countries. In our own University Clinic 95 % of pill-users take a sub-50 pill; only 5 % use a 50 JAg pill on medical indication. This decrease in estrogen dosage, which is usually accompanied by a decrease of progestational component as well, has resulted in a decrease of thromboembolic disease. Factors that are still important to consider are diabetes mellitus, hypertension, adipositas and smoking. Good selection of patients together with the prescribing where possible of sub-50 pills may result in the numbers of compli- cations and side-effects being close to those encountered in the control group.

Spis treści

Section I: The Present Situation in General.- 1 What does it take to develop a new contraceptive?.- 2 Influence of mass media on the attitude towards oral contraceptives.- 3 Absence of correlation between oral contraceptive usage and ischemic heart disease.- 4 Australian experiences with hormonal contraception over two decades.- Discussion.- Section II: Clinical Experiences with the New Triphasic Oral Contraceptive Moderator: A. A. Haspels.- 5 Clinical performance of a triphasic administration of ethinyl estradiol and levonorgestrel in comparison with the 30 + 150 j456?g fixed-dose regime.- 6 Effects of switching from higher-dose oral contraceptives to a triphasic preparation.- 7 Clinical experience with triphasic oral contraceptives (TrigynonR) in six hundred cycles.- 8 Acceptability of low-dose oral contraceptives: results of a randomized Swedish multicenter study comparing a triphasic (TrionettaR) and a fixed-dose combination (Neovletta*).- Discussion.- Section III: Metabolism and the Hemostatic System.- 9 Lipoproteins and the estrogenicity of oral contraceptives.- 10 Effects of a triphasic and a biphasic oral contraceptive on various hemostatic parameters.- 11 Comparative investigation of oral contraceptives using randomized, prospective protocols.- Discussion.- Section IV: Hypothalamic-Pituitary-Ovarian Axis and the Endometrium.- 12 Vaginal, cervical and endometrial changes during the triphasic pill.- 13 Sensitivity changes of the pituitary during administration of a triphasic oral contraceptive.- 14 Influence of hormonal contraception on the maturation process of the hypothalamic-pituitary-ovarian axis.- Discussion.- Round Table.- Concluding Summary-R. Rolland.