Oestrogen, Progestogen and Liver‐function Tests

Abstract

When considering the reason for the abnormal liver-function tests in subjects to whom oral contraceptives have been administered it has been suggested that either the oestrogen or the progestogen component is responsible for the changes in these tests (Adlercreutz, 1964; Eisalo et al., 1964; Boake et nl., 1965; Stoll et al., 1966) or that a synergetic action of the two components takes place (Borglin, 1965; Eisalo et al., 1965).The present study concerns liver-function tests in subjects who have received synthetic oestrogen, progestin and their combinations. Synthetic steroids widely used as oral contraceptives were employed in the study. Subjects and MethodsThe series consisted of 40 postmenopausal women divided into four groups, each comprising 10 subjects. For 28 consecutive days the first group was administered daily 0.15 mg of mestranol (3-methoxy-l7a-ethinyloestradiol), the second group 5 mg of lynoestrenol (1 7a-ethinyloestrenol), the third 0.05 mg of 17aethinyloestradiol, and the fourth 4 mg of megestrol acetate (1 7a-acetoxy-6-methylpreg-4.6-dien-3.20-dione). One woman refused to take mestranol on trial. After the initial phase the experiment was continued for a consecutive period of 28 days by combining the treatment in the oestrogen groups with the progestin compound and in the progestin groups with the

Developments in jaundice

“…It is possible that the combination of oestrogen and a progestagen, particularly a 19-nor compound, may increase their individual toxicity. Eisalo et al (1968) found this, lynoestrenol plus mestranol further impairing the liver function tests which had been altered by lynoestrenol alone. Alternatively the metabolism of 19-norprogestagens to the very active ethinyloestradiol (Brown & Blair, 1960) may fully explain the hepatic toxicity of progestagens.…”

“…There is some evidence that the similar but unsaturated substitution groups in the 17a-position in 19-norprogestagens do likewise, and Eisalo, Heino & Rasanen (1968), for example, have recently found that the 19-norprogestagen lynoestrenol induced more abnormal liver function tests than did the progestagen megestrol, which has a different structure. Kleiner et al (1965) suggested that progestagens are the hepatotoxic component of the pill, for they found that oestradiol (2-5 mg/day) for 10 days had no effect on the liver function of normal women, even on the BSP transport maxima.…”

Effects of a Low-oestrogen Oral Contraceptive on Urinary Excretion of Luteinizing Hormone and Ovarian Steroids

“…There are other differences in the effect of these two oestrogens on carbohydrate metabolism (Di Paola et al, 1968), liver function (Eisalo et al, 1968), and also vitamin B6 metabolism (Luhby et al, 1971). Clearly, further studies of a similar nature to this with a combined contraceptive formulation comprising ethinyl oestradiol instead of mestranol at a dose of 50 ug or even less and 1 mg of norethisterone will provide further interesting data, and these studies are under way.…”