Clinical use of oral contraceptives administered vaginally: a case report
Sullivan-Nelson, M.; Kuller, J.A.; Zacur, H.A.
Fertility and Sterility 52(5): 864-866
1989
ISSN/ISBN: 0015-0282 PMID: 2806624 Document Number: 368203
Effectiveness in cycle control and plasma steroid levels were monitored in a woman with promyelocytic leukemia being treated with chemotherapy, given 2 combined oral contraceptives given vaginally. The 18-year old woman had been taking an oral contraceptive containing 50 mcg mestranol and 1 mg norethindrone during the 3 months since she began treatment for leukemia. After recurrence of leukemia, she developed acute hemorrhagic mucocitis and inability to swallow while on cytosine arabinoside, daunorubicin and etoposide. She was administered 2 of the same oral contraceptives daily per vagina, and her withdrawal bleeding continued to be suppressed for 6 weeks while receiving transfusions for aplastic marrow. Compared to 10 normal women taking 30 mcg ethinyl estradiol and 100 mcg norethindrone, the patient's plasma level of radioimmunoassayed ethinyl estradiol was comparable as to concentration and peak time. Her level of norethindrone was lower, with the highest level measured at 12 hours, compared to a peak at 2 hours in women taking one pill orally.