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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because of their efficacy and ease of use, oral contraceptives (OCs) have become the most widespread contraceptive in France and the world. OCs also have the advantages of reversibility and increasing safety and innocuity due to lower doses of ethinyl estradiol (EE) and improved progestins. The contraceptive effect of OCs depends primarily on suppression of ovulation, endometrial atrophy, and modifications in the cervical mucus rendering it inhospitable to sperm. The three major types of OCs are combined pills of either standard or low dose, sequential pills, and low-dose progestins. Higher dose progestins may also be used for contraception but they are usually reserved for treatment of uterine and mammary pathology. Standard-dose combined OCs contain 50 mcg of EE, while low-dose formulations contain 20-40 mcg. Combined pills are monophasic, biphasic, or triphasic. The advantages of combined OCs are their great efficacy and antigonadotropic power, which allows total steroid doses to be reduced. They may however cause cycle problems due to endometrial atrophy. The long-term administration of EE alone for the first cycle phase with sequential pills has been shown to increase risks of breast disorders, endometrial dysplasia and uterine cancer. Sequential pills are now used only for short-term treatment in specific indications. Low-dose progestins provide a low and continuous dose of progestin. Ovulation is not always inhibited, and persisting secretion of LH and FSH involves some follicular maturation. Contraceptive efficacy relies solely on local effects on the cervical mucus, endometrial atrophy, and decreased tubal motility. The failure rate and incidence of ectopic pregnancy are higher and cycle problems are frequent. The only advantage is the absence of estrogen for women with contraindications. The side effects of combined OCs may include alterations of glucose tolerance and of lipid profiles, increases of blood pressure, modifications in coagulation factors leading to increased thromboembolic risk proportional to the estrogen dose, and increased risk of biliary lithiasis and certain types of jaundice. Combined OCs have not been formally proven to increase risk of cervical cancer, and they are known to have protective effects against ovarian tumors. Most adolescents tolerate standard-dose combined OCs quite well. Low-dose combined pills or high-dose progestins may be appropriate for women over 40. Combined OCs are contraindicated in cases of hypertension, although low-dose progestins may be prescribed. Combined OCs are contraindicated for many diabetics and in all cases of hyperlipidemia and in smokers over 35.
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PMID:[Oral contraception]. 827 87