Oral contraceptives agents (OCA) have been in use for more than two decades, and at the present time, 150 to 200 million women are using the preparations. Apart from their gynecologic influence, the hormones have been shown to affect a number of metabolic and nutritional processes, some advantageously and others disadvantageously. Concern over the nutritional status of females consuming OCA prompted this review. Eight vitamins and three minerals were investigated. Contraceptive steroid ingestion was shown to depress the physiologic levels of six nutrients (riboflavin, pyridoxine, folacin, vitamin B12, ascorbic acid and zinc), elevate the levels of three others (vitamin K, iron and copper) and provide little or no change in one (alpha tocopherol) and questionable increases in another (vitamin A). It was concluded that females consuming OCA should pay particular attention to vitamin and mineral intake and, if warranted, consume physiologic supplements of needed nutrients.
PIP: The state of knowledge concerning the effects of OCs (oral contraceptives) and mineral metabolism is assessed. A review of the literature indicates that OCs depress the levels of Vitamin B2, or riboflavin, Vitamin B6, or pyridoxine, folacin, Vitamin B12, Vitamin C, or ascorbic acid, zinc and elevate levels of Vitamin K, copper, and iron. The ingestion of OCs produces little effect on Vitamin E, or alpha tocopherol. Findings on the effects of OC ingestion on Vitamin A are ambiguous. OC users have 50%-80% higher serum levels of Vitamin A than nonusers; however, OC users may have a greater need for Vitamin A than nonusers. The need for riboflavin may also be higher for OC users. OC users need more pyridoxine and riboflavin is needed to oxidize pyridoxine phosphate to pyridoxal phosphate. Most studies support the contention that OC usage leads to a deficiency of Vitamin B6. Approximately 80% of all women using OCs for 6 or more months experience abnormal typtophan metabolism. In order to correct this problem, 25 mg daily, or 12 times the normal daily requirement, is needed. Some investigators recommend givng this dosage to women, who experience abnormal tryptophan metabolism, while others warn that the long-term effects of such high dosages are unknown. Most investigators recommend that OC users, with Vitamin B12 or Vitamin C deficiencies, should be given supplementary vitamins.