[Potential side effects of oral contraception: hirsutism and hypertension]

The question was investigated whether there is a correlation between the clinical signs of hirsutism hypertension body mass index (BMI) and urinary excretion of androgenic 7-oxosteroid hormone derivatives in order to differentiate women whom such steroid contraceptives are contraindicated. A total of 17 women with the average age of 29 years were studied who had used oral contraceptives (OCs) in the previous 10 years and presented with hypertension and/or hirsutism at the Institute of Medical Cosmetology. In addition to the basic cosmetological treatment systolic and diastolic blood pressure was measured in all of them and the BMI was calculated. In a 24-hour urine sample the excretion of seven derivatives of 17-oxosteroid were determined by thin layer chromatography. The patients had been using Biogest Norbiogest or Neogest OCs. The use OCs was halted at least one month before the steroid analysis in order to avoid the interference of hormones with the preparations themselves. Statistically significant correlation was found between the combination of 11-beta-hydroxyandrosterone plus oxoetiocholanolone plus 11-beta-hydroxyetiocholanolone and systolic blood pressure (r=0.4257 p < 0.01). Furthermore the positive correlation between blood pressure and the excretion of androsterone approached statistical significance (r=0.3449) as did the negative correlation between BMI and etiocholanolone (r=0.4183). The fact that in the preparations used the proportion of synthetic gestagen was sufficient may be associated with the decline of SHBG (serum hormone binding globulin) along with the increase of free testosterone. OCs of the third generation do not have androgenic effects and they have reduced cardiovascular and hypertensive risk. Therefore it is recommended for young women to use third generation OCs who otherwise used only gestagen for menstrual disorder. The minimum dose of estrogen in combination with progestin in those OCs provides substantial protection for the endometrium which is already important for young women who think forward to their menopause.