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November 22, 1965

Abnormal Liver Function and Synthetic Estrogens

Author Affiliations

Port Arthur, Tex

JAMA. 1965;194(8):933. doi:10.1001/jama.1965.03090210097033

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To The Editor:—  The use of synthetic estrogen-progesterone combinations for the control of ovulation and menstrual disturbances has become widespread in recent years. Therefore, any observation that may reveal an untoward side effect of these substances is of considerable significance.A 25-year-old white woman had given birth to her third child one year ago. The pregnancy had been uncomplicated. Prior to her confinement, she was seen in our clinic on several occasions for minor ailments. Shortly after delivery, she started to take norethindrone with mestranol (Ortho-Novum, 2-mg tablets) for 20 days of each cycle. After using this steroid combination for nine months, she experienced anorexia, nausea, malaise, fatigue, and postprandial indigestion and lost a few pounds of weight. She also had periods of trembling and hunger, relieved by sweets and sugar. A six-hour glucose tolerance test had shown a blood glucose concentration of 65 mg/100 ml in the four-hour specimen.

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