Control of conception by hormonal steroids.

Experience with the use of progestinestrogen preparations as oral contraceptives indicates that they inhibit fertility by preventing ovulation and that their action is clearly a physiological process. Their efficiency as antifertility agents is extraordinary. An examination of their physiological effects over many years of use indicates that actions to be expected from the hormonal properties of the steroidal components occur but that none of these constitute pathological phenomena. Rather, we observe a state conditioned by the rather constant hormonal milieu resulting from the particular dosages and regimes of use. Thus far, despite use by millions of women, none of the alleged pathological adverse reactions (such as thromboembolism) to the drugs have been established as more than coincidental. Clearly beneficial effects are inherent not only in the avoidance of risks attendant upon pregnancy but also in improvements in menstrual function (regularity, reduction of hypermenorrhea and dysmenorrhea) and perhaps in a prophylactic effect upon certain abnormalities of the reproductive tract (cervical anaplasia, endometrial cystic and adenomatous hyperplasia). Psychogenic phenomena due to use of oral contraceptives are difficult to measure, but beneficial effects would seem to outweigh adverse ones.