Single monthly administration of the anti-progestagen Org 31710 in users of the 75 μg desogestrel progestagen-only pill: effects on pituitary–ovarian activity
2000
textabstractEndocrine and ultrasound effects were studied of an intermittent (every 28
days) oral administration of 150 mg of the anti-progestagen Org 31710
during the continued daily use of 75 microg desogestrel (DSG) for
progestagen-only contraception. A randomized, double-blind,
placebo-controlled two-centre study was conducted in 50 healthy
volunteers. Serum luteinizing hormone (LH), follicle stimulating hormone
(FSH), oestradiol and progesterone concentrations, and follicle number and
size were studied, as well as endometrial thickness, which was assessed by
transvaginal sonography at least twice weekly during a single medication
cycle (cycle 3-5). Forty-eight women were evaluated (Org 31710, n = 25;
placebo, n = 23). Seven ovulations were observed in the treated group
versus none in the placebo group. LH concentrations were higher on days 9
and 11 and oestradiol concentrations lower on day 3 in the treated group,
irrespective of whether ovulation occurred. No parameter could predict
ovulation. Endometrial thickness was greater on cycle days 7-13 and 19 in
the treated group. However, within the Org 31710 group, no significant
differences were found in volunteers who did or did not ovulate. Observed
differences may be attributed to a competitive effect of Org 31710 with
progestagen-induced suppression of the pituitary-ovarian axis, altered
oestradiol feedback mechanisms, and/or altered receptor availability.
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