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Wissenschaftlicher Aufsatz, 2011
The results of 90 apparently healthy women between the age of 17 to 39 years old on oral contraceptives for not less than six months tested for hematological parameters for the month of July, 2011and comparing the results obtained with the local reference values showed that ;Rbc: 4.40 × 109 /L, Hb:12.38g/dl, Ht: 38.1L/L, MCV:86.94FL, MCH:28.8pg, MCHC:31.50 %, RDW-CV: 12.98, Total WBC:7.40× 109 /L, Platelet 272× 109 /L all values in mean were recorded. It was observed that 1.1% were thrombocytopenic and anemic, whereas 3.3% were of the mild leucocytosis. Nevertheless, the results were not clinical and statistical significant.
Finally the study concluded that no significant effects were observed on hematological parameters due to oral contraceptive use and the women of Porto Novo should continue to use oral contraceptives correctly to prevent unwanted and or unnecessary pregnancies with the instruction of a Nursing officer in charge of the reproductive section.
Combination contraceptives are most effective means for contraception excluding sterilization.
Contraceptives are hormonal agents, combination oral contraceptives contain both an estrogen and a progestogen. Endogenous estrogens are largely responsible for the development and maintenance of female reproductive system and secondary sexual characteristics. Estrogens act through binding to nuclear receptors in estrogen responsive tissues Circulating estrogens modulate the pituitary secretion of the gonadotropins, luteinizing hormone(LH) and follicle stimulating hormone (FSH), through a negative feedback mechanism. Modern progestogens such as gestodene have been developed in order to provide women with an oral contraceptive agent with more selective progestational activity that improves cycle control, minimizes metabolic changes and adverse events and effectively prevents pregnancy.
Of these agents, gestodene has been shown to be a particularly effective inhibitor of ovarian activity with a pronounced progestational effect on the endometrium in both preclinical and clinical trials, Gast MJ (1996). Gestodene has been combined with low doses of ethinylestradiol to provide low- dose combination oral contraceptive preparations. While low dose combination oral contraceptives are the most widely prescribed form of oral contraceptive today and have a low failure rate in terms of unintended pregnancies, Aguiar et al (1996) reported that approximately 50% of all women who begins taking oral contraceptives discontinue their use within one year. Of the factors attributed to non-compliance and or discontinuation of it according to Aguiar and co-workers, include, poor cycle control, amenorrhea, headache, weight gain and breast tenderness.
Dr. Heli Bathija(1998) reported higher hemoglobin and Ferritin levels on women taking oral contraceptives and concluded that hemoglobin and Ferritin levels are influenced by the use of contraceptives and that the hormonal contraceptives included in his studies have a beneficial effects on these parameters.
Professor Vessey M P (1993) wrote that oral contraceptives offer protection against both epithelial cancer of the ovary and cancer of the endometrium and protection increases with duration of use and persists for at least 15 years after stopping its use. According to Professor Vessey, well established risks of combined oral contraceptives are mainly vascular ones, comprising effects on acute myocardial infarction, thrombotic stroke, haemorrhagic stroke and venous thrombosis and embolism.
Dr. Brown and co-workers (1988) expressed that oral contraceptives protects against menstrual bleeding problems and thereby reduce the risk of iron- deficiency anaemia. They also afford protection against benign breast disease Brinton L.A. et al (1981).
Mooij PN et al (1992) reported no significant difference on hematological parameters due to oral contraceptive use in women but serum iron status were significantly increased for the users of oral contraceptive. According to Charles JP et al (1975), serum folate levels were not significantly affected and there were no macrocytosis and no hypersegemented polymorphonuclear leucocytes among the users of oral contraceptives. This shows that oral contraceptive agents do not cause folate deficiency anaemia in otherwise normal subjects.
The experiment of Irwin Fisch & Shanna Freedman (1975) demonstrated that red blood cells variables were lesser significant in women that are taking oral contraceptives, however total leucocyte count were slightly raised.
Dr. Burton J L(1967) reported that serum iron and serum total iron binding capacity were strikingly elevated in women taken oral contraceptives and this was attributed in part to a response to circulating oestrogens and or progesterone. Dr. Godsland et al (1983) investigated haematological indices and metabolic effects of oral contraceptives and concluded that no statistically significant effects were observed. England & Bain BJ (1976) reported that some form of oral contraceptives raise the leucocyte count.
In this study, the aim was to investigate the effect of oral contraceptives on some haematological parameters of Red blood cell count, Haemoglobin, Haematocrit, Total white cell count, Platelet count, Mean cell volume (MCV), Mean cell haemoglobin (MCH), Mean cell haemoglobin concentration (MCHC) and Red cell distribution width in coefficient variation, comparing all the values obtained from the women on oral contraceptives with the local reference values.
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