Int. J. Gynaecol. Ohstet., 1984, 22: 111-115 International Federation of Gynaecology & Obstetrics EFFECT OF ORAL CONTRACEPTION ON SERUM BILE ACID MAMDOUH M. SHAABANa, SHARAF A. GHANEIMAHb, MOHAMED A. MOHAMEDb, SOAD ABDEL-CHAP!Ib and SAYED A. MOSTAFAa Departments of aOhstetrics and Gynaecology and bBiochemistry, Assiut University, Assiut, Egypt. (Received June 27th, 1983) (Accepted September 24th. 1983) Abstract zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Shaaban M M , Ghaneimah SA, M ohamed M A, Abdel-Ghani S, Mostafa SA, (Departments of Obstetrics and Gynaecology, and Biochem- istq,, Assiut University, Assiut, Egy pt). Effect of oral contraception on serum bile acid. Int J Gynaecol Obstet 22: 111-115, 1984 Eighteen normal women, 20 with active urinary schistosomiasis, and 25 with past histories of viral hepatitis were given a con- traceptive pill containing 0.05 mg ethinyl estradiol and 0.5 mg levonorgestrel for six consecutive cycles. Serum bile acid levels were measured by enzyme immunoassay method before and after 3 and 6 months of use. Simultaneously, conventional liver function tests (serum bilirubin, transaminases, alkaline phosphatase and albumin) were done. Serum bile acid concentration was not significantly changed by the contraceptive use in any group. The concentration of choly lgly cine (the main bile acid measured) did not corre- late with the values of any of the other tests. Pretreatment values of serum cholylglycine were significantly lower in the past-hepatitis group. The difference w as maintained during treatment. Keywords: Oral contraception; Serum bile acids; Conventional liver function tests; Normal women; Schistosomiasis; Past viral hepatitis. 0020-7292184iSO3.00 D 1984 ‘International k-ederatlon of Gynaecology & Obstetrics Published and Printed in Ireland Introduction There are data indicating that the estrogens and progestogens contained in oral contracep- tives impair hepatic excretory processes and induce certain hepatic enzymes [ 1,5 ,101. The interaction between the contraceptive steroids and certain environmental conditions, includ- ing endemic diseases, may accentuate such effects. Two endemic diseases that are com- mon in rural parts of Egypt are particularly important, namely, schistosomiasis and viral hepatitis. The schistosoma ova filter in the liver and ultimately cause hepatic fibrosis. Women with evident schistosomal hepatic involvement are not given hormonal contra- ception, but those with urinary or intestinal schistosomiasis per se are not denied this treatment. It is possible that some of these women have clinically undetected liver patho- logic conditions that may interact adversely with the contraceptive pills. The same possi- bility exists for women with past viral hepa- titis. The present clinical practice is that women who have been considered clinically and biochemically cured of viral hepatitis can be given oral contraceptives. Some of them may have residual liver dysfunction that might be accentuated by the contraceptive steroids. A previous study of our group [8] has shown that women with active urinary and/ or intestinal schistosomiasis who do not have clinically or biochemically evident hepatic disease do not run an increased risk of Int J Gynaecol Obstet 22