[Internal medicine problems regarding contraception. Part I].

The increasing distaste for the "pill' is mainly due to uncritical comments disseminated by the mass media and to the rational and irrational anxieties of women. The doses of steroidal hormones in today's hormonal contraceptive agents are only a small fraction of the amounts used in the past. Consequently, the occurrence of adverse reactions is much smaller; thus, tendency to thromboembolism has decreased by more than 25% with ovulation inhibitors containing only 50 gamma of EE, and thrombotic incidents are very rare if the so-called "micropill" (30 gamma EE) is given. Hypertension is observed in 1--2.5%, but can be detected by regular blood pressure control. Glucose tolerance is dependent on the estrogen dose and the type of gestagen used. By choosing contraceptive agents with low estrogen doses in combination with a gestagen of the pregnane type, or with the so-called "minipill", the danger of glucose deterioration can be avoided. Plasma triglycerides are markedly increased. The risk of hepatic complications increases with the duration of treatment. Jaundice seems to be mainly due to C17-alkyl substituted steroids. A correlation has been assumed between episodes of pancreatitis and increased lipoprotein concentrations due to treatment with oral contraceptive agents. In contrast, they have a protective effect in rheumatoid arthritis. The absolute and relative contraindications for oral contraceptive agents are listed.