A clinico-pathological study of Neogynon as a new oral contraceptive steroid.

Clinical experience and a pathology study of 184 women on Neogynon (.25 mg d-norgestrel and .05 mg of 17-ethinyl estradiol micro 20) was assessed for a total of 3129 cycles. 53 women were nursing babies before use of the pill and 44 continued to do so throughout pill usage. Endometrial biopsies were taken premenstrually during the period of full hormonal effect for 40 cases before and then 6-12 months after initiation of pill usage; biopsies were studied for effect of the combined steroid on the building up of endometrium. The combination pill was 100% effective with no failures. 23 cases (12.5%) failed to continue through the 18th cycle. 4 cases stopped after the 2nd cycle and 6 more after the 4th; the remaining stopped after the 12th cycle. No change in menstrual pattern was noticed in 136 (73.9%) of the cases; 14 presented with menorrhagia and endometrial biopsy of one of these showed regressive and mixed endometrial changes. 2 cases of intermenstrual spotting were reported. Hypomenorrhea was reported in 16 cases. Side effects were generally effects on the central nervous system: 7 cases of headache and dizziness 7 cases of mild depression and 3 cases of sexual anorexia. No gastrointestinal side effects were reported. 44 cases (of 53) continued lactation and 9 noticed a progressive decrease in the amount of milk produced. 8 cases gained weight and 13 lost 2 enough to quit using the pills. Hair loss was a noticeable complaint in 5 cases. Endometrial biopsies revealed grades of arrest of endometrial development. 85% showed a resting endometrial pattern whereas 15% were atrophic. Endometrial response was rather irregular and mainly of the mixed type in 90% of the cases and about 10% were proliferative.