Abstract
To determine the effect of microdose norgestrel on the hypothalamic-pituitary ovarian axis cervical mucus properties vaginal cytology and endometrial histology 6 healthy women were studied during 1 control and 1 treated menstrual cycle during which 75 mg norgestrel was administrered daily for 30 days. Gonadotropic and steroid hormones were assayed from blood and 24-hour urine every other day (daily during mid-cycle). Cervical mucus was tested every 1-2 days for quantity viscosity pH ferning spinnbarkeit cellularity sperm penetration and by protein electrophoresis. The womens basal body temperature and karyopyknotic index were determined and correlated with hormonal and cervical mucus studies. Endometrial biopsies were obtained between day 26-28 of both cycles. Results showed that norgestrel inhibited or suppressed luteinizing hormone and follicle-stiumulating hormone peaks and decreased progesterone in serum and pregnanediol in urine. Urinary estrogens increased in 3 women and decreased in 3. The cervical mucus became scanty viscous and cellular and demonstrated reduced spinnbarkeit and ferning; sperm migration through mucus was inhibited with 1 exception. Cervical mucus protein patterns revealed 3 ovulatory and 3 anovulatory changes. It appeared that breakthrough bleeding occurred essentially during anovulatory cycles. Typical biphasic karyopyknotic index was observed in only 2 cases. Endometrial changes incompatible with normal implantation occurred in all women. There were no significant differences in excretion of 17-ketosteroids and 17-hydroxysteroids during control and treated cycles. Data suggest norgestrel may exert contraceptive action by changing physical and chemical properties of cervical mucus altering endometrium inhibiting ovulation and disturbing hypothalamic pituitary ovarian function.
Published Version
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