Abstract. The aim of the study was to measure the concentrations of plasma homocysteine in premeno pausal and postmenopausal women, and to examine a possible relationship between plasma homocysteine and oestrogen status. Homocysteine metabolism was studied by a standardized oral methionine loading test, and oestrogen status was assessed by the measurement of serum 17/3-oestradiol. Forty-six pre menopausal and 26 postmenopausal healthy women without a history of vascular disease or adverse preg nancy outcome were recruited by public advertise ment. The main outcome measures were the concen trations of fasting and postmethionine plasma homo cysteine, and serum 17/3-oestradiol. Fasting plasma homocysteine concentrations (mean ± SD) were sig nificantly higher in postmenopausal women as coinpared to premenopausal women (12 ± 4 /¿mol L" 1 and 10 ± 3/imol L" 1, respectively) as well as postmethionine plasma homocysteine concentrations (46 ± 16 //mol L-1 and 32 ± 9 /¿mol L ' 1, respec tively). In premenopausal women, postmethionine plasma homocysteine was negatively and significantly correlated to serum 17/3-oestradiol (r = -0-34). It is concluded that plasma homocysteine concentrations, both fasting and after methionine loading, are signifi cantly higher in postmenopausal women than in pre menopausal women. In premenopausal women, the higher concentrations of serum 17/3-oestradiol may account in part for the lower concentrations of post methionine plasma homocysteine.

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Spotting and bleeding are among the most common side-effects associated with oral contraceptives during the first 3 months of use and are prime determinants of whether a new user will continue their use. Desogestrel, gestodene, and norgestimate are new progestogens that have been developed, in part, to minimize these side-effects, However, comparative evaluation of these preparations is difficult because of the subjective nature of bleeding and because available studies are often too small and difficult to compare. To address these limitations, we used meta-analysis to analyze data from 2956 women, totalling 16 506 cycles. Data were collected during a multicenter clinical trial.Oral contraceptives containing desogestrel or norgestimate had significantly more spotting or bleeding at each cycle than did the gestodene-containing preparation. During cycle one to six, the combined group of desogestrel and norgestimate users averaged a 62% higher prevalence for spotting and bleeding after adjustment for age, s~tudy site, and recency and consistency for other factors that confounded this association.Other factors were found independently to predict the occurrence of spotting or bleeding. In the first cycle, recency of oral contraceptive use was the strongest predictor. In addition, women who had formerly used or had never used oral contraceptives were approximately two-and-a-half times more likely to have these side-effects that women who had switched from another preparation. This difference steadily and rapidly subsided with continued use, becoming nonsignificant by the third cycle. Inconsistent use was associated with a 70% increase of spotting and bleeding during the first cycle and a 440% increase in later cycles, while smokers experienced 20-90% more spotting and bleeding than non-smokers. Neither weight nor age influenced the likelihood of spotting or bleeding. 36 Abstracts CLINICAL COMPARISON OF MONOPHASIC ORAL CONTRACEPTIVE PREPARATIONS OF GESTODENE/ETHINYLESTRADIOL AND DES OGESTREL/ETHINYLESTRADIOL