Second Chapter
Dr. Álvaro Monterrosa Castro, MD
Other Miscellaneous Effects
Combined oral contraceptives are not associated with the development of gastric or duodenal ulcer or with inflammatory bowel disease; they should not be recommended in women with intestinal malabsorption disorders due to possible contraceptive failure (7).
Very recently, Gardyn et al (161) have taken into consideration, when evaluating a small number of oral contraceptive users, that the pill reduces blood levels of vitamin B12, without reaching clinical significance and with a return to the normal range in all women after one month of stopping the combined oral contraceptive.
Very rarely, combined oral contraceptives have been associated with a reduction in libido and depression. The latter situation occurs especially with high-dose oral contraceptives, since estrogen in high doses can inhibit tryptophan synthesis. If episodes of depression related to the use of the pill occur, the phenomenon can be reversed with the administration of pydridoxin (7).
Previous studies have found an association between joint ligament laxity and changes in estrogen, progesterone and relaxin levels. Other authors, evaluating changes in the laxity of the articular ligaments in women between the ages of 20 and 21, users and non-users of oral contraceptives, come to the conclusion that the use of the pill is not associated with greater or lesser laxity in the joints. articular ligaments.
The use of combined oral contraceptives in patients affected by sickle cell anemia has long been controversial, as it is considered that the effects of the pill can be synergistic with hematological disorders and produce undesirable effects on blood coagulation.
(Read Also: The Potential Risks of Oral Contraception in Perspective)
Influence of oral contraceptives
Yoong and collaborators (F-5) designed a comparative study to study the influence that oral contraceptives exert on the erythrocytes of patients with sickle cell anemia, and concluded by not finding significant modifications in different groups, with different family planning methods, It does not seem that the hormonal components present in oral contraceptives worsen the deformity of the erythrocytes in women who suffer from this disease.
Sickle cell anemia is an incurable pathology that mainly affects the Afro-Caribbean population. Chloasma, a pigmentation of parts of the face, was a side effect observed with macrodose oral contraceptives.
It is a rarity with modern oral contraceptives, but it should be kept in mind that it gradually fades when the pill is stopped, without disappearing completely, with skin whiteners being useful (7). Little has been studied about general well-being and symptoms related to fluid retention.
Pill Evaluation
Apter et al (163) have conducted an open, multicenter, uncontrolled study to evaluate the pill containing 30 ug/day of ethinyl estradiol plus 3 mg/day of drospirenone on general well-being in 336 women over six treatment cycles. , using for the first time the PGWBI, Psychological General Well Being Index, a suitable instrument to measure subjective well-being and psychological distress, because it covers relevant aspects of emotional changes related to hormonal fluctuations, such as depressed mood, anxiety, irritability and lack of energy.
There was a significant increase in global markers, which means improvement in general well-being. There was also improvement in various parameters such as positive well-being, anxiety, depressed mood, self-control, general health and vitality.
In parallel, a reduction in the incidence and severity of somatic symptoms associated with the menstrual cycle was observed, which is related to the favorable natural antimineralocorticoid effect of drospirenone. To date, it is the first study (163) that uses PGWBI in the evaluation of an oral contraceptive.
Since quality of life is one of the least investigated aspects of oral contraceptives, it is necessary to carry out other studies, taking into consideration other doses and other combinations, to establish the impact that combined oral contraceptives have on quality of life. and general well-being.
Dr. Álvaro Monterrosa Castro, MD
