Oral contraceptives and liver function

Abstract

SYNOPSIS

Hepatic Lesions Caused by Anabolic and Contraceptive Steroids

“…Oral contraceptives have a number of physiologic effects on the liver which include decreased bile flow, diminished secretion of organic anions and decreased synthesis and secretion of bile acids; these effects have been extensively reviewed [1,61,98,128]. Retention of bromosulfophthalein (B.S.P.)…”

“…Estrogens and progestins can increase the activity of many enzymes and alter the concentration of many plasma proteins [61]. Increased synthesis of delta-aminolevulinic acid synthetase may provoke attacks of acute porphyria in genetically susceptible individuals [I].…”

Occurrence of Hepatic Impairment in Women Jaundiced by Oral Contraceptives and in Their Mothers and Sisters

“…It is debatable which of the two hormones in oral contraceptives, the oestrogen or the progestogen, is responsible for the reaction (1, 7). Most authors, however, are of the opinion that the oestrogens are mainly responsible for the reaction but that progestogens may play a part through metabolites with oestrogenic activity (7). Steroid hormones can influence various factors involved in biliary excretion such as metabolic conjugation (8), hepatic uptake and secretion (1 1) and the permeability of the biliary tree (6).…”

“…Whether or not oral contraceptives should be prescribed for women with a history of other forms of hepatic disease or dysfunction is still not clear (7,15,16). In our series seven of the women had had infectious hepatitis before, but it is not possible to say whether this had any effect on the development of jaundice during oral contraceptive treatment since no details of the source of their disease are available.…”

Hormonal Steroid Contraceptives1 IV

“…Authorities vary in their attitudes toward the use of the pill in patients with ordinary portal cirrhosis or a history of viral hepatitis'. The whole subject is well reviewed by Hargreaves (1970). Fortunately there is universal agreement that all changes remit rapidly on cessation of the oral contraceptive.…”