Stubblefield P G
Harvard Medical School, Boston, Massachusetts.
Int J Fertil. 1986;31 SU [UPDATE]:4-12.
The synthetic steroid hormones used in oral contraceptives differ in their effects and potencies. Because all low-dose preparations currently sold in the United States contain the same estrogen, the differences among progestin components are of clinical significance. Synthetic progestins may have progestational, estrogenic, antiestrogenic, and androgenic effects; all have antiovulatory effects. Means for measuring the different effects of steroid hormones, ranging from animal assays to human studies, are reviewed. The problems of generalizing from effects of one steroid in an animal system to combination steroids in the human system are emphasized. Our evolving concept of desirable and undesirable effects of progestins is reviewed, the concept of minimal effective dose introduced, and a conclusion suggested from the limited human data available. A plan for the selection of contraceptive steroids for human use is proposed.
口服避孕药中使用的合成甾体激素在作用和效力方面存在差异。由于目前在美国销售的所有低剂量制剂都含有相同的雌激素，因此孕激素成分之间的差异具有临床意义。合成孕激素可能具有孕激素、雌激素、抗雌激素和雄激素作用；所有这些都具有抑制排卵的作用。本文综述了从动物试验到人体研究等测量甾体激素不同作用的方法。强调了将动物系统中一种甾体激素的作用推广到人体系统中联合甾体激素作用时存在的问题。本文回顾了我们对孕激素理想和非理想作用不断演变的概念，引入了最小有效剂量的概念，并根据有限的人体数据提出了结论。提出了一项选择用于人类的避孕甾体激素的计划。
