Abstract
Once a small group of unsuitable patients have been identified by clinical observations, the great majority of women requiring contraception are best treated by combined-type oral contraceptives. Some of these contain steroids now known to require metabolic activation and such products are best avoided. Dose-related changes in a wide range of biochemical parameters can be demonstrated following administration of oral contraceptive steroids. Most of these are induced by the estrogen component, so that the lowest estrogen dose compatible with efficacy and acceptability should be used. This appears to be 30 ug/d ethynylestradiol. Only one currently available progestogen (norgestrel) possesses appreciable anti-estrogenic actions in women and is therefore the progestogen of choice in most cases.
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