Metabolism and Infarction

pills, which require a higher dosage while oestrogen only is being given. The minipill consisting of progestagen only has had its ups and downs. This type of preparation did not make headway after being withdrawn (unnecessarily it appears) for a while when beagle bitches treated with chlormadinone acteate developed neoplastic breast nodules. The higher incidence of irregular bleeding and lesser reliability when compared with the low oestrogen-progestagen combination ensured first place for the latter. Nor have the combination pills been successfully challenged by postpartum injections or long-acting implants, both of which are unsuited to British needs. There are many conditions-a predisposition to thrombosis and diabetes head the list-in which the use of a combination oral contraceptive is contraindicated, but the choice of a lowdose oestrogen-progestagen combination or an intrauterine device will cover the needs of most women in Britain today. Both have disadvantages which make their ultimate replacement likely. None of the many alternatives such as antioestrogens or immunization procedures have fulfilled their promise from the earlier, experimental stage. A revolution is probably around the corner but the message from the laboratory is that the corner may be some years away.