HISTOLOGICAL CHANGES IN OVARIAN AND UTERINE BLOOD-VESSELS AFTER USE OF ORAL-CONTRACEPTIVE AGENTS (ESTROGEN-GESTAGEN COMBINATIONS) AND GESTAGENS

The article determened the incidence of degeneration (thickening of the intima intimal degeneration degeneration of the media and elastic membranes) of the middle-sized arteries in the ovaries and uteri of patients taking oral contraceptive gestagens and estrogen-gestagen combinations. Samples of ovarian and uterine tissue were examined from 34 women ranging from 18 to 47 years of age: 6 samples were from normal subjects 7 from women who did not take contraceptives and suffered from diseases of the uterus and/or ovaries 14 from women who had taken oral contraceptives 4 from patients who had discontinued use of oral contraceptives and 3 from biopsies taken at Caesarian section. The incidence of degenerated middle-sized arteries varied from 22% to 97% in the women presently using oral contraceptives. The average number of sclerotic arteries was 66% which was much higher than the average percentage found in the 6 normal ovaries (16%) the 7 ovaries removed for diseases (12%) and the 3 ovarian biopsies obtained from Caesarian sections (11%) but not significantly different from the vascular degeneration in the 4 women who had ceased oral contraceptive treatment for between 4 and 15 cycles (38%-55% p greater than .10). Vascular degeneration is more frequent in older normal women than younger normal women but there was no significant difference between age groups in the amount of vascular degeneration in oral contraceptive users (p greater than .10). It is concluded that gestagen intake accelerates degeneration of the middle-sized ovarian and uterine arteries and that it may shrink the ovaries make them more brittle and make the tissue of both the ovaries and uterus more brittle. New pills with smaller gestagen doses may not have this effect. It is recommended that gestagens should not be given to younger women but only to older women with more children who need an effective contraceptive.