Abstract
Symptoms related to use of oral contraceptives in patients seen by an otolaryngologist are discussed. Pressure in the ears due to obstructed eustacian tubes are often seen in pregnancy and in the luteal phase of the menstrual cycle. Whether ear pressure is the consequence of vascular congestion or of the cyclic response of the nasal mucosa to female hormones is unknown but patients can often find relief by switching from sequential to combined pills. Vertigo unsteadiness and imbalance are often noted a few days before menstruation during pill cycles. Their relationship with thrombosis is unknown. In menopause estrogen relieves vertigo. Distortion of sound is probably caused by patulous or obstructed eustacian tubes and requires discontinuing the pill. Nasal congestion can often be relieved by sequential pills because nasal mucous glands respond like the genital tract to estrogen in hypogonadal women. Premenstrual headache related to traction or alteration of cranial blood vessels can be treated with 2 mg Halotestin (fluoxymesterone) sublingually. Migraine headaches often respond to progestin because these hormones raise the threshhold of the reticular system and have an anitconvulsive effect. The possibility that the pill like pregnancy precipitates otosclerosis has not been proven.
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More From: Transactions. Section on Ophthalmology. American Academy of Ophthalmology and Otolaryngology
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