Abstract

PIP: A literature review on hepatic effects of oral contraceptive (OC) use is presented. OC use reduces the excretory functions of the liver and reduces bile secretion. The metabolism of the enzymes, particularly estrogens, from OCs in the liver is competitive with the metabolism of countless other substances. Hepatomegalia is a common morphological effect of OC use. In most cases of OC induced cholestasis, a preexistent liver ailment is involved. In many cases, patients with a pregnancy cholestasis develop cholestasis during OC use. The bromasulfalene transport is lengthened among these patients, and increases in transaminase, SGOT, and SGPT levels are observed. OC use affects the liver according to 2 patterns. In the first, the liver cells are damaged; this form is not common. The second, more common form, is cholestatic in nature. This second form can also be divided into 2 groups. An allergy-type reaction to OC use is indicated by a marked increase in transaminase levels. The other cholestatic reaction is dependent on dosage and type of preparation and can develop in any OC user. This reaction is analogous to intrahepatic pregnancy cholestasis and is indicated by hyperbilirubinemia and elevated phosphotase activity. Viral hepatitis has not been proven to be a contraindication to OC use. The Budd-Chiari syndrome, peliosi hepatis and sinusoidal dilatation are vascular complications observed to be related to OC use. Hepatocellular adenoma and focal nodular hyperplasia are benign liver tumors which are associated with OC use. Cases have been reported in which such tumors have become malignant. Although hepatic tumors are infrequent, a causal relationship is possible. Gallstones more often occur among OC users, probably due to the estrogen component. OC use is contraindicated for women with cardiovascular complications or disorders of the excretory functions of the liver.