Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T07:17:07.797Z Has data issue: false hasContentIssue false
  • English
  • Français

Side effects of steroid contraception

Published online by Cambridge University Press:  27 September 2011

J. J. Gellén
J. J. Gellén
Affiliation:
Department of Obstetrics and Gynaecology, University Medical School, Szeged, Hungary
Get access Rights & Permissions [Opens in a new window]

Summary

Side effects of steroid contraception during lactation are discussed and followed by a review of the relevant literature. It appears that oestrogen has an inhibiting effect on lactation performance, but progestogen alone does not. Most of the undesirable systemic side effects of oral contraceptives on the mother are connected with the relative excess or deficiency of the oestrogen and/or the progestogen component. It is likely that a low oestrogen content preparation causes no dangerous side effects. There are few data about the appearance of contraceptive steroids in breast milk. Probably only a small proportion of the steroids are excreted into the milk. Any adverse effects, on the infant, such as slow weight gain, neonatal breast hypertrophy and breast milk jaundice, are dependent on the two preceding factors. It is doubtful whether the small amount of contraceptive steroids contained in modern pills exert any influence on the fetus. Although further examinations are necessary, the low dosage of progestogen and oestrogen combined contraceptives given at fully established lactation under close control seems to be advantageous to both mothers and their infants.

Type
IV. Steroid contraception during lactation
Information
Journal of Biosocial Science , Volume 9 , supplement S4: Fertility Regulation During Human Lactation , 1977 , pp. 149 - 164
Copyright
Copyright © Cambridge University Press 1977

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anon (1976) The pill and raised blood pressure. Br. med. J. 1, 58.Google Scholar
Arias, I.M.Gartner, L.M., Seifer, S. & Furman, M. (1964) Prolonged neonatal unconjugated hyperbilirubinaemia associated with breast feeding and a steroid, pregnane-3/alpha/, 20/beta/-diol, in maternal milk that inhibits glucuronide formation in vitro. J. clin. Invest. 43, 2037.CrossRefGoogle Scholar
Åstedt, B. (1972) On fibrinolysis. Acta. obstet. gynec. scand. Suppl. 18, 18.Google Scholar
Bahgat, M.R., Atkinson, L.E., Brinson, A.O. & Segal, S.J. (1975) Treatment of postpartum rhesus monkeys with progestogen: appearance in milk and effects on lactation. Contraception, 12, 665.CrossRefGoogle ScholarPubMed
Barnardo, D., Stothers, I. & Sharratt, M. (1972) Breast-milk jaundice and the pill. Br. med. J. 2, 348.CrossRefGoogle ScholarPubMed
Barsivala, V. (1973) The effect of oral contraceptives on concentration of various components of human milk. Contraception, 7, 307.CrossRefGoogle Scholar
Bergstein, N.A.M. (1976) Clinical efficacy, acceptability and metabolic effects of low dose combined oral contraceptives. Acta obstet. gynec. scand. Suppl. 54, 51.CrossRefGoogle ScholarPubMed
Beuselinck, A. (1967) Klinische resultaten bekomen met het 6-alpha-methyl-17-alpha-ethinylestrenol tijdens volledige borstvoeding. Bull. Soc. r. Belge Gynec. Obstet. 37, 365.Google Scholar
Bhiraleus, T.C. & Koetsawang, S. (1970) Effects of oral gestagens upon lactation. In: Postpartum Family Planning: A Report of the International Program, p. 345. Edited by Zatuchni, G.I., McGraw-Hill, New York.Google Scholar
Borglin, N. & Sandholm, L. (1971) Effect of oral contraceptives on lactation. Fert. Steril. 22, 39.Google Scholar
Buchanan, R. (1975) Breast Feeding: an Aid to Infant Health and Fertility Control. Population Reports, Series J. No. 4, p. 49. George Washington University Medical Center, Washington, DC.Google Scholar
Chinnatamby, S. (1967) Effects of oral contraception on lactation. In: Proceedings of the 8th International Conference of the IPPF, p. 263. Santiago, 1967. IPPF, London.Google Scholar
Chopra, J.G. (1972) Effect of steroid contraceptives on lactation. Am. J. clin. Nutr. 25, 1202.CrossRefGoogle ScholarPubMed
Cronin, T.J. (1968) Influence of lactation on ovulation. Lancet, ii, [422.CrossRefGoogle Scholar
Crosignani, P.G. & Robyn, C. (Eds.) (1977) Prolactin and Human Reproduction. Academic Press, New York.Google Scholar
Curtis, E.M. (1964) Oral contraceptive feminization in a normal male infant. J. Obstet. Gynec. 23, 295.Google Scholar
Curtis, E.M., Newson, N.H. & Grant, R.P. (1963) Oral contraceptives in the immediate puerperium. J. med. Assoc. Ga, 52, 425.Google Scholar
Drill, V.A. (1972) Oral contraceptives and thromboembolic disease. I. Prospective and retrospective studies. J. Am. med. Ass. 219, 583.CrossRefGoogle ScholarPubMed
Drill, V.A. (1974) Benign cholestatic jaundice of pregnancy and benign cholestatic jaundice from oral contraceptives. Am. J. Obstet. Gynec. 119, 165.CrossRefGoogle ScholarPubMed
Drill, V.A. & Calhoun, D.W. (1968) Oral contraceptives and thromboembolic disease. J. Am. med. Ass. 206, 77.CrossRefGoogle ScholarPubMed
Elstein, M., Morris, S.E., Groom, G.V., Jenner, D.A., Scarisbrick, J.J. & Cameron, E.H.D. (1976) Studies on low-dose oral contraceptives: cervical mucus and plasma hormone changes in relation to circulating D-norgestrel and 17α-ethynyl estradiol concentrations. Fert. Steril. 27, 982.CrossRefGoogle ScholarPubMed
Fisch, I.R., Freedman, S.H. & Myatt, A.V. (1972) Oral contraceptives, pregnancy, and blood pressure. J. Am. med. Ass. 222, 1507.CrossRefGoogle ScholarPubMed
Fotherby, K. & Warren, R.J. (1976) Bioavailability of contraceptive steroids from capsules. Contraception, 14, 261.Google Scholar
Frank, R., Alpern, W.M. & Eshbaugh, D.E. (1969) Oral contraception started early in the puerperium. A clinical study. Am. J. Obstet. Gynec. 103, 112.CrossRefGoogle ScholarPubMed
Gioiosa, R. (1955) Incidence of pregnancy during lactation in 500 cases. Am. J. Obstet. Gynec. 70, 162.CrossRefGoogle ScholarPubMed
Gjønnaess, H., Fagerhol, M.K. & Stormorken, H. (1975) Studies on coagulation and fibrinolysis in blood from puerperial women with and without oestrogen treatment. J. Obstet. Gynaec. Br. Commonw. 82, 151.CrossRefGoogle Scholar
Goldman, J.A., Eckerling, B., Zukerman, Z. & Mannheimer, S. (1971) Blood glucose and plasma insulin levels with ethynodiol diacetate oral contraceptive. J. Obstet. Gynaec. Br. Commonw. 78, 255.CrossRefGoogle ScholarPubMed
Goldzieher, J.W., Rice-Wray, E., Schulz-Contreras, M. & Aranda-Cosell, A. (1963) Fertility following termination of contraceptives with norethindrone. Am. J. Obstet. Gynec. 84, 1474.CrossRefGoogle Scholar
Gomez-Rogers, C., Ibarra-Polo, A.A., Faundes, A. & Guiloff, E. (1967) Effect of IUD and other contraceptive methods on lactation. In: Proceedings of the 8th International Conference of the IPPF, p. 328. Santiago, 1967. IPPF, London.Google Scholar
Gonzales, C. (1970) Continuous microdoses of chlormadinone during lactation. Ginecol. Obstet. Mex. 28, 563.Google Scholar
Greenblatt, J. & Koch-Weser, J. (1974) Oral contraceptives and hypertension. J. Obstet. Gynec. 44, 442.Google Scholar
Guiloff, E., Ibarra-Polo, A., Zanartu, J., Toscannini, C., Mischler, T.W. & Gomez-Rogers, C. (1974) Effect of contraception on lactation. Am. J. Obstet. Gynec. 118, 42.CrossRefGoogle ScholarPubMed
Hefnawi, F., Fawzi, G., Badraoui, M.H.H., Kader, N.H.A. & Bahgat, M.H. (1970) Attempts to select a suitable hormonal contraceptive during lactation. In: Proc. 6th World Congress of Obstetrics and Gynecology, New York, p. 16. Williams & Wilkins, Baltimore.Google Scholar
Herbst, A.L., Kurman, R.J. & Scully, R.E. (1972) Vaginal and cervical abnormalities after exposure to stilboestrol in utero. J. Obstet. Gynec. 40, 287.Google ScholarPubMed
Howie, P.W., Evans, K., Forbes, C.D. & Prentice, C.R.M. (1975) Effects of stilboestrol and quinestrol upon coagulation and fibrinolysis during the puerperium. J. Obstet. Gynaec. Br. Commonw. 82, 968.Google Scholar
Ibrahim, A. & El-Tawil, N.Z. (1968) The effect of a new low dosage oral contraceptive pill on lactation. Intern. Surgery, 49, 561.Google ScholarPubMed
Janerich, D.T., Piper, J.M. & Glebatis, D.M. (1974) Oral contraceptives and congenital limb-reduction defects. New Engl. J. Med. 291, 697.CrossRefGoogle ScholarPubMed
Kader, M.M., Aziz, M.T.A., Bahgat, M.R., Kamal, I. et al. (1975) Effect of two long acting injectable progestogens on lactation in the human. Acta. biol. med. germ. 34, 1199.Google ScholarPubMed
Kaern, T. (1967) Effect of an oral contraceptive immediately postpartum on initiation of lactation. Br. med. J. 3, 644.CrossRefGoogle ScholarPubMed
Kamal, I., Hefnawi, F., Ghoneim, M., Talaat, M., Younis, N., Tagni, A. & Abdalla, M. (1969) Clinical, biochemical, and experimental studies on lactation. II. Clinical effects of gestagens on lactation. Am. J. Obstet. Gynec. 105, 324.CrossRefGoogle ScholarPubMed
Karim, M., Ammar, R., El Mahgoub, S., El Ganzoury, B., Fikri, F. & Abdou, U. (1971) Injected progestogen and lactation. Br. med. J. 1, 200.Google Scholar
Kelley, H. W., Miles, Ph.A., Buster, J.R. & Scragg, W.H. (1976) Adenocarcinoma of the endometrium in women taking sequential oral contraceptives. J. Obstet. Gynec. 47, 200.Google ScholarPubMed
Kistner, R.W. (1967) Therapeutic application of progestational compounds. In: Advances of Obstetrics and Gynecology, Vol. 1. Edited by Marcus, S. L. & Marcus, C. C.. Williams & Wilkins, Baltimore.Google Scholar
Koetsawang, S., Bhiraleus, P. & Chiemprajert, T. (1972) Effects of oral contraceptives on lactation. Fert. Steril. 23, 24.CrossRefGoogle ScholarPubMed
Kora, S.J. (1969) Effect of oral contraceptives on lactation. Fert. Steril. 20, 419.CrossRefGoogle ScholarPubMed
Kullander, S. & Källén, B. (1976) A prospective study of drugs and pregnancy. 3. Hormones. Acta obstet. gynec. scand. 55, 221.CrossRefGoogle ScholarPubMed
Laragh, J.H. (1972) Oral contraceptive hypertension. Postgrad. Med. 52, 98.CrossRefGoogle ScholarPubMed
Larsson-Cohn, V. (1975) Oral contraceptives and vitamins: a review. Am. J. Obstet. Gynec. 121, 84.CrossRefGoogle ScholarPubMed
Laumas, K.R., Malkani, P.K. & Bhatnagar, S. (1967) Radioactivity in the breast milk of lactating women after oral administration of 3H-norethynodrel. Am. J. Obstet. Gynec. 98, 411.Google Scholar
Lauritzen, C. & Lehmann, W.D. (1965) Die Bedeutung der Steroidhormone für Hyperbilirubinämie und Icterus neonatorum. Geburtsh. Frauenheilk. 25, 962.Google Scholar
Lauritzen, C. & Lehmann, W.D. (1966a) Die Bedeutung der Steroidhormone für die Entstehung von Hyperbilirubinämie und Icterus neonatorum. Z. Kinderheilk. 95, 143.CrossRefGoogle Scholar
Lauritzen, C. & Lehmann, W.D. (1966b) Einfluss von Steroidhormonen auf die Bilirubinwerte beim Neugeborenen. 2. Geburtsh. Frauenheilk. 26, 17.Google Scholar
Lawson, W., Stroud, S.W. & Williams, P.C. (1944) Oestrogen excretion in milk from oestrogenized cattle. J. Endocr. 4, 83.Google Scholar
Lyon, F.A. (1975) The development of adenocarcinoma of the endometrium in young women receiving long-term sequential oral contraception. Am. J. Obstet. Gynec. 123, 299.CrossRefGoogle ScholarPubMed
Marriq, P. & Oddo, G. (1974) La gynécomastie induite chezle nouvenu-né par le leit maternal? Un accident rare des contraceptifs oraux. Nouv. Presse Med. 3, 41.Google Scholar
Mercier-Parot, L. (1955) Disturban troubles du developpement postnatal du rat aprés administration de cortisone a la mere gestante ou allaitante. C.r. Ass. anat. 240, 2259.Google Scholar
Miller, G.H. & Hughes, L.R. (1970) Lactation and genital involution effects of a new low-dose oral contraceptive on breast feeding mothers and their infants. J. Obstet. Gynec. 35, 44.Google ScholarPubMed
Nora, J.J. & Nora, A.H. (1974) Can the pill cause birth defects? New Engl. J. Med. 291, 731.CrossRefGoogle ScholarPubMed
Paulsen, C. (1965) Progestin metabolism: special reference to estrogenic pathways. Metabolism, 14, 313.CrossRefGoogle ScholarPubMed
Pincus, G., Bialy, G. & Layne, D.S. (1966) Radioactivity in the milk of subjects receiving radioactive 19-norsteroids. Nature, Lond. 212, 924.CrossRefGoogle ScholarPubMed
Poller, L. & Thomson, J.M. (1966) Clotting factors during oral contraception: further report. Br. med. J. 2, 23.CrossRefGoogle Scholar
Ponce Casares, H.J. (1969) Daily administration of microdoses of chlormadinone and its effect on breast feeding. Ginecol. Obstet. Mex. 25, 295.Google Scholar
Posner, N.A., Silverstone, F.A., Tobin, E.H. & Brever, J. (1973) Changes in carbohydrate tolerance during long-term oral contraception. Am. J. Obstet. Gynec. 123, 119.CrossRefGoogle Scholar
Rice-Wray, E., Avila, C. & Gutierrez, J. (1968) Norgestrel and ethinyl estradiol: a new low-dosage oral agent for fertility control. J. Obstet. Gynec. 31, 368.Google Scholar
Rice-Wray, E., Goldzieher, J.W. & Aranda-Rosell, A. (1963) Oral progestins in fertility control. A comparative study. Fert. Steril. 14, 402.Google Scholar
Sas, M., Gellén, J. & Viski, S. (1969a) Steroidausscheidung und Serum-Bilirubinwerte bei mit Muttermilch und bei künstlich ernährten Neugeborenen. Zentbl. Gynak. 91, 1296.Google Scholar
Sas, M., Viski, S. & Gellén, J. (1969b) Der Steroidgehalt der Frauenmilch. Arch. Gynaek. 207, 452.Google Scholar
Schwarz, R. & Hickon, R. Jr, (1975) Suppression of lactation. Contemp. Obstet. Gynec. 5, 103.Google Scholar
Semm, K. & Dittmar, F.W. (1966) Post-partum ovulation: inhibition and milk yield. Curr. Ther. Res. 8, 48.Google ScholarPubMed
Silverberg, S.G. & Makowski, E.L. (1975) Endometrial carcinoma in young women taking oral contraceptive agents. J. Obstet. Gynec. 46, 503.Google ScholarPubMed
Soyka, L.F. (1975) Prenatal exposure to stilboestrol and adenocarcinoma of the female genital tract: the pediatrician's responsibility. Pediatrics, 55, 456.CrossRefGoogle ScholarPubMed
Spellacy, W.N., Newton, R.E., Buhi, W.C. & Birk, S.A. (1976) Lipid and carbohydrate metabolic studies after one year of megestrol acetate treatment. Fert. Steril. 27, 157Google Scholar
Steele, S.J. (1968) Inhibition of lactation by oestrogens. Br. med. J. 4, 587.CrossRefGoogle ScholarPubMed
Thomson, A.M., Hytten, F.E. & Black, A.E. (1975) Lactation and reproduction. Bull. Wld Hlth Org. 52, 337.Google ScholarPubMed
Van der Molen, H.J., Hart, P.G., & Wijmenga, H.G. (1969) Studies with 4-14C-lynestrenol in normal and lactating women. Acta endocr., Copenh. 61, 255.Google ScholarPubMed
Vessey, M.P. & Doll, R. (1968) Investigation of relation between use of oral contraceptives and thromboembolic disease. Br. med. J. 2, 199.Google Scholar
Vorherr, H. (1973) Contraception after abortion and post-partum. Am. J. Obstet. Gynec. 117, 1002.CrossRefGoogle ScholarPubMed
Warren, R.J. & Fotherby, K. (1975) Metabolism of D and L Norgestrel in humans. Drug Res. 25, 964.Google ScholarPubMed
Wijmenga, H.G. & Van der Molen, H.J. (1969) Studies with 4-14C-mestranol in lactating women. Acta. endocr., Copenh. 61, 665.Google ScholarPubMed
Wong, Y.K. & Wood, B.S.B. (1971) Breast-milk jaundice and oral contraceptives. Br. med. J. 4, 403.CrossRefGoogle ScholarPubMed
Wynn, V., Adams, P., Oakley, N. & Seed, M. (1974) Metabolic investigations in women taking 30 μg ethinyl-oestradiol plus 150 μg d-norgestrel. In: The 2nd International Norgestrel Symposium, p. 47. Edited by Fairweather, D. V. I.. Excerpta Medica, Amsterdam.Google Scholar
Zanartu, J., Aguilera, E., Munoz, G. & Peliowsky, H. (1976) Effect of a long-acting contraceptive progestogen on lactation. J. Obstet. Gynec. 47, 174.Google Scholar
Zanartu, J., Dabancens, A., Oberti, C., Rodriquez-Bravo, R. & Garcia-Huidobro, M. (1974) Low-dosage oral progestogens to control fertility. J. Obstet. Gynec. 43, 87.Google Scholar
Zech, P., Rifle, G. & Lindner, A. (1975) Malignant hypertension with irreversible renal failure due to oral contraceptives. Br. med. J. 4, 326.Google Scholar