No abstract

No abstract

A high percentage of women receiving 5 mg. of norethynodrel with mestranol in cyclic fashion for contraception have decreased glucose tolerance. Ten per cent have elevated fasting levels, 20 per cent have elevated one-hour levels and 46 per cent have elevated two-hour levels (greater than our normal mean + 2 standard deviations of 105, 156 and 113 mg./lOO ml., respectively). The incidence of abnormal glucose tolerance is greater in women with a family history of diabetes than in those without a history.It seems reasonable to associate the change in glucose tolerance with the "pseudo-pregnancy" produced by the drug. Many women who have decreased glucose tolerance during natural pregnancy later become permanently diabetic. If this is true of those women with decreased glucose during drug treatment, then this response may identify the prediabetic.In some women taking the ovulatory suppressant, norethynodrel and mestranol,* the plasma proteinbound iodine and the plasma cortisol levels may be elevated. 2 -3 These changes do not result in any clinical evidence of thyroid or adrenocortical hyperactivity and are similar to those seen during administration of estrogens or in pregnancy. We have found a metabolic change, decreased glucose tolerance, in a high percentage of women taking this drug. MATERIALS AND METHODSThe patients were receiving norethynodrel and mestranol in the usual cyclic manner for contraception, 5 mg. a day for twenty days beginning on the fifth day of each menstrual cycle.They were referred at random from the gynecology clinic. Of the fifty-nine women examined, fifty-one were of Puerto Rican origin. Their intake was high in carbohydrate, containing at least 250 to 350 gm. a day, and * Supplied as Enovid from G. D. Searle and Company, and containing in each 5 mg. tablet of norethynodrel (17 alphaethynyl-17 hydroxy-5-(io)-estren-3-one), and .075 mg. of mestranol (ethynylestradiol 3-methyl ether).