[Oral contraception and liver function] Oral antikonsepsjon og leverfunksjon.

Bergsjo P
Tidsskrift for den Norske Laegeforening. 1973 Mar 30; 93:583-588.

A survey of literature reporting disturbances in liver function which accompany oral contraceptive use is presented. The survey comprises 21 reports of over 102 patients. 43 of 88 patients who gave information about previous pregnancies had experienced jaundice or pruritis during a previous pregnancy. The symptoms of jaundice usually appeared in the 1st cycle of contraceptive use. In all cases where such tests were taken, the serum bilirubin, alkaline phosphate, serum transaminase, and bromosulphalein (BSP) retention levels were elevated. The pathogenesis seems to have both toxic and genetic aspects. Among women using oral contraceptives who show no predisposition to liver dysfunction, changes in liver function tests seem to be temporary. BSP retention and transaminase tests are the most sensitive to these changes. Low dosage gestagen tablets seem to have little influence on liver function. Both the estrogen mestranol and gestagen lynestrol can cause liver dysfunction. Jaundice caused by oral contraceptive use seems to be caused by intrahepatic cholestasis; a genetic factor is indicated in the pathogenesis of the cholestasis. Oral contraceptives seems to disturb the transportation phase, not the storage phase of bile secretion. The Dubin-Johnson and the Budd-Chiari syndromes can be caused by use of oral contraceptives. Porphyria, cirrhosis of the liver, and bile disturbances can be aggravated by oral contraceptive use. The breaking down of drugs in the liver may be influenced by oral contraceptive use.

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