Oral Contraception and Ovarian Function

Low-dose ovulation inhibitors are being used increasingly to reduce the adverse metabolic effects of oral contraceptives containing high doses of hormones. Both reduction and variation of dosage are applied during the individual treatment cycle. It has been observed that low-dose ovulation inhibitors are more likely to cause breakthrough bleeding and spotting in the first treatment cycles. Furthermore, mastodynia and mastopathy are frequently seen in women taking low-dose contraceptives. Functional ovarian cysts were detected by ultrasound in a high percentage of cases where lower abdominal pain persisted over a period of time [6]. Where ovarian cysts were not present, maturing follicles were found in some women. These clinical symptoms are often associated with elevated endogenous estrogen concentrations, an observation that has been confirmed by Spellacy et al. [9], Kuttenn et al. [3] and Gompel and Kuttenn [2].