Stimulation of Gastric Intrinsic Factor Secretion.

It is uncertain whether the abnormal findings indicate impaired liver function. It has been suggested that they may be a result of the pseudopregnancy state (Tyler, 1964). , While the B.S.P.-removal mechanisms have been found to be impaired in normal pregnancy (Combes et al., 1963), the serum-transaminase levels and the standard B.S.P. retention are not abnormal (Christhilf et al., 1950 ; Combes et al., 1963; Ikonen, 1964). Mueller and Kappas (1964) in their patients, who were mostly post-menopausal, showed that natural oestrogens increased B.S.P. retention, but did not affect serumtransaminase levels. Lyndiol, with an oestrogenic component of 0.15 mg. per tablet, provoked abnormal serum-transaminase levels and B.S.P. retention more often than did Volidan with only 0.05 mg. of 17a-ethinyloestradiol per tablet. This may be merely due to the fact that Lyndiol contains three times as much oestrogen as Volidan, but it is also possible that the 3-methoxy radical potentiates the effect of oestrogen on the liver. On the other hand, 1 7a-ethynyloestrenol itself or one of its metabolites may also be an active principle. There is evidence that in man 19-norsteroids are converted into oestrogenic compounds (Goldzieher, 1964), and the progestogen component of Lyndiol might in this way potentiate the effect of synthetic oestrogen on the liver. It seems likely that oestrogens interfere with the transport of B.S.P. through the liver but not with its conjugation (Mueller and Kappas, 1964), as evidenced by the abnormally low B.S.P. clearance in post-menopausal women treated with oral contraceptives (Eisalo et al., 1964). Finally, it was surprising to find an almost identical incidence of abnormal results in the Orgametril and Volidan groups. In conclusion, the serum transaminase levels and the B.S.P. retention should be determined in women taking oral contraceptive drugs, and withdrawal of medication should be considered in the event of abnormal results. Summary