Steroid Contraceptives and Women’s Response

1. Front Matter

   Pages i-ix

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2. Why Pharmacokinetics? An Introduction And Overview

   • Rachel C. Snow, Lucy E. Wilson

   Pages 1-7

3. Selection of a Contraceptive: What Guides A Woman?

   • Pramilla Senanayake

   Pages 9-14

4. Contraceptives and Women’s Complaints &— Preliminary Results From the Post-Marketing Surveillance of Norplant R

   • Y. Ahmed, S. Boccard, T. Farley, O. Meirik

   Pages 15-26

5. Regional and Individual Variation in Bleeding Patterns Associated with Steroid Contraception

   • Elizabeth M. Belsey

   Pages 27-53

6. Variability in Menstrual Bleeding Patterns: Comparing Treated and Untreated Menstrual Cycles

   • Sioḃán D. Harlow

   Pages 55-59

7. Contraceptive Use and Discontinuation: The Social Meaning of Side-Effects

   • Carla Makhlouf Obermeyer

   Pages 61-68

8. Population and Delivery Systems: Variability in Pharmacokevettcs of Long-Acting Injectable Contraceptives

   • Josue Garza-Flores, Sang Guo-Wei, Peter E. Hall

   Pages 69-83

9. Pharmacology of The Ethynyl Estrogens in Various Countries

   • Joseph W. Goldzieher

   Pages 85-89

10. Pharmacodynamics of Norplant R Implants

    • Harold A. Nash, Dale N. Robertson

    Pages 91-102

11. Pharmacokinetic Drug Interactions with Oral Contraceptives

    • D. J. Back, M. L’E. Orme

    Pages 103-123

12. A Critical Evaluation of the Pharmacokinetics of Contraceptive Steroids

    • Kenneth Fotherby

    Pages 125-132

13. A Short Review on the Sources of Variability in Pharmacokinetic Parameters of Sex Steroids: Comment on the Paper by K. Fotherby

    • Michael Hümpel

    Pages 133-141

14. Diet and Estrogen Metabolism

    • Christopher Longcope

    Pages 143-151

15. Diet, Circulating Estrogen Levels and Estrogen Excretion

    • Barry R. Goldin

    Pages 153-169

16. Variations in Estrogen Metabolism

    • Leon Bradlow

    Pages 171-177

17. Body Fat, Fat Topography and Endogenous Steroid Dynamics

    • Rachel Snow

    Pages 179-186

18. Steroid Contraceptives and Women’s Response: Program Considerations from the Quality of Care Perspective

    • Joan Kaufman

    Pages 187-197

19. Bringing a Client and Life-Cycle Perspective to Scientific Evidence

    • Judith Bruce

    Pages 199-205

20. Commentary on Presentation of Dr. Pramilla Senanayake

    • Gary S. Grubb

    Pages 207-211

Pharmacokinetic variability of contraceptive steroids is a relatively under-explored area of contraceptive research, and hardly a common point of discussion among those who plan and deliver family planning services. Nevertheless, numerous independent studies over the last 15 years have indicated that women in different regions of the world vary in their pharmacokinetic response to contraceptive steroids. The causes of such variability are not known, but it has important consequences for contraceptive effectiveness. It may also offer insight to the basis of contraceptive side-effects. The impetus for this volume was to collect documentation of pharmacokinetic variability of contraceptive steroids, and to explore both the possible causes and implications of these data. Factors known to affect steroid pharmacokinetics, such as concurrent use of specific medications, are reviewed by Back and Orme. Other factors known to affect endogenous steroid dynamics are presented in chapters by Bradlow, Longcope, Goldin and Snow, because of their possible role in contraceptive steroid pharmacokinetics.

• kinetics
• metabolism
• pharmacokinetics
• pharmacology
• research
• steroids

• Department of Population and International Health, Harvard School of Public Health, Boston, USA

  Rachel Snow

• World Health Organization, Geneva 27, Switzerland

  Peter Hall

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