Nutrition during oral contraceptive treatment
PIP: Oral contraceptive (OC) use has been associated with 50 different metabolic changes but few women require increased amounts of nutrients to prevent deficiencies. Plasma triglyceride levels are markedly increased by OCs, but no consistent changes have been found in plasma cholesterol, fatty acids, or phospholipids. Small elevations in blood glucose and plasma insulin levels result from OC use, and plasma albumin is decreased and the alpha and beta globulins and fibrinogen are increased. Women on the pill show slight increases in the urinary excretion of some of the amino acids and decreases in some of the blood amino acids. Tryptophan metabolism is altered by OC use; changes in parameters of Vitamin-B6 metabolism are seen and Vitamin-B6 is used as a cofactor for several enzymes in the tryptophan pathway. At the beginning of OC use the retention of dietary nitrogen increases, and weight gain may result. The estrogens in OCs reduce plasma calcium, phosphorus, and magnesium. Most studies demonstrate an increase in serum iron and copper and a decrease in plasma zinc. Studies have also found an increase in plasma levels of Vitamin-A and a decrease of carotene, Vitamin-E, ascorbic acid, folacin, Vitamin-B12, and Vitamin-B6. 20% of OC users have enlarged cervical and vaginal cells as a result of abnormal folacin metabolism. The abnormality is corrected by oral folacin supplementation. Some women respond to OC treatment with biochemical signs of Vitamin-B6 deficiency and depression. These women should receive 20-40 mg Vitamin-B6 as a supplement.