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Extra info for Reproductive Endocrinology And Fertility
Another mechanism may be decreased menstrual ﬂow. Despite these studies, the topic remains controversial. Some critics state that most of these studies have used patients with symptomatic disease. Hence, there may be milder cases in which the OC does not protect against the long-term pelvic scarring of asymptomatic PID . A 40% reduction in the risk of ovarian malignancy as well as borderline epithelial ovarian cancer has been reported . Of interest, the effect seems to occur within several cycles of initiation of oral contraceptive therapy and appears to last for 10–15 years after discontinuance .
Their preliminary data indicate that parenteral testosterone improves both endothelial-dependent (ﬂow mediated) and endothelium-independent (GTN mediated) brachial artery vasodilation in postmenopausal women using long-term estrogen therapy. Androgens have also been found lately to play a role in the cardiac syndrome X. This syndrome is described as the triad of angina pectoris, a positive exercise test for myocardial ischemia, and angiographically normal coronary arteries. Although syndrome X does not result in an increased risk of cardiovascular mortality, the symptoms are often trou- 50 Sylvestre and Gelfand blesome and unresponsive to conventional antianginal therapy.
In 30 Perlman and Sanﬁlippo terms of VTE, the studies from the ultralow-dose OC are comparable, but again conclusions may be premature. In the literature to date, in one study a 25-year-old smoker had a myocardial infarction while taking 100-µg levonorgestrel and 20-µg ethinyl estradiol OC . Another study showed one patient taking the 150-µg desogestrel/ 20-µg ethinyl estradiol OC developed severe hypertension . In that same study, another patient had a thromboembolic event while taking 75-µg gestodene/20-µg ethinyl estradiol, but did smoke and have a family history .