Control of human fertility with estrogens and various combinations of estrogens and progestogens. (Experimental study)

Abstract:  The cyclic use of natural (estrone sulphate) or synthetic estrogens (ethinyl estradiol; 3-methyl ester of ethinyl estradiol) is shown to be clinically capable of inhibiting fertility, probably by a mechanism which interferes with ovulation. Out of the 3 estrogens used in this experiment, there were "escape" phenomena with estrone sulphate, used in a dose of 3.7 mg. The adverse side effects and signs of intolerance shown in some patients treated with a combination of estrogens and proge stogens, especially during the 1st cycles of treatment, are mainly related to the estrogen contained in the compound. The symptoms are similar with both ethinyl estradiol and its 3-methyl ester. If the combined treatment with estrogens and progestogens if properly followed, fertility inhibition occurs in 100% of the cases. Failures of this therapy are rarely due to intolerance and dropping out, but mainly to forgetting to take the drug. The use of a simpler formula, which elimin ates the need for calculations with respect to the menstruation date, 21 days with treatment and 7 without, is just as effective in inhibiting fertility and the characteristics of menstrual bleeding remain largely unaffected. The reduction of the amount of progestogen leaves the fertility inhibiting property unaffected, if the minimum effective dose of estrogen is maintained. Since the progestogen is the more complex and expensive substance, a reduction would considerably lower the market price of the drug.