The Allahabad Farmer Vol. LXVIII, January - 2013 No. 2Audiological pr<strong>of</strong>ile <strong>in</strong> Women us<strong>in</strong>g prolongedOral ContraceptiveApala Gupta • , Prema Devi • and V.P. Sah ABSTRACTIt is only <strong>in</strong> the last two decades that people have been able to be provided withsafe and effective means <strong>of</strong> controll<strong>in</strong>g their fertility with the safe guard. Thereis some physical alteration along with the most vital auditory and vestibularmechanism.AIM : To pr<strong>of</strong>ile the effect <strong>of</strong> oral contraceptive on audition and vestibularsystem.METHODOLOGY : The study has been carried out with subjects <strong>of</strong> 10 healthyFemale OCP users s<strong>in</strong>ce m<strong>in</strong>imum <strong>of</strong> 6 month period between the age <strong>of</strong> 25-35yrs old, with out any significant medical history. a screen<strong>in</strong>g questionnaireadmistered to rule out the detailed case history. All the subjects were followedan ENT evaluation along Audiological test battery, <strong>in</strong>clud<strong>in</strong>g PTA, SPEECHAUDIOMETRY and IMPEDANCE AUDIOMETRY.RESULT : The follow<strong>in</strong>g study shows that the OCP user represents variouspathophysiological alteration <strong>in</strong> auditory and vestibular sensation, represnt<strong>in</strong>gssigns <strong>of</strong> decrease sensitivity <strong>of</strong> hear<strong>in</strong>g; however the alterations are depends onthe prolongations <strong>of</strong> OCP.TERMINOLOGY- OCP- Oral contraceptive pillsINTRODUCTIONNearly 40% <strong>of</strong> married women <strong>in</strong> the country have adopted measures, 36% us<strong>in</strong>gmodern methods and 4% relay<strong>in</strong>g on traditional techniques, accord<strong>in</strong>g to the nationalfamily health survey (NFHS).1992-93 conducted by the <strong>in</strong>ternational <strong>in</strong>stitute for populationsciences, Bombay for the union m<strong>in</strong>istry <strong>of</strong> health and family welfare the survey covers24 states.•BASLP III, • MASLP, Asst Director•, • , Ali Yavar Jung National Institute <strong>of</strong> Hear<strong>in</strong>g Handicap, New Delhi116
Apala Gupta, Prema Devi and V.P. SahAmong the major states, the higher ever use <strong>of</strong> any contraceptive method wasrecorded <strong>in</strong> Kerala (75%) and lowest <strong>in</strong> Uttar Pradesh (26%). Women go through monthlyreproductive cycle which starts dur<strong>in</strong>g puberty and usually last dur<strong>in</strong>g all their reproductivelife stopp<strong>in</strong>g at menopause. These cycles prepare the female reproductive tract forpregnancy. Comb<strong>in</strong>ed estrogen and progesterone pills (contraceptives) taken orally for aperiod <strong>of</strong> 3 weeks have <strong>in</strong>voluntary action prevent<strong>in</strong>g fertilization from tak<strong>in</strong>g place.This occurs through gonadotroph<strong>in</strong> secretion <strong>in</strong>hibition by the pituitary act<strong>in</strong>g on thehypothalamus.The progesterone agent present <strong>in</strong> the pill suppresses Leut<strong>in</strong>iz<strong>in</strong>gHormonesecretion and the estrogen agent is responsible for the FSH secretion surpression.theuse <strong>of</strong> these contraceptive pills by women may cause different adverse reactions suchas immune,metabolic,nutritional,psychiatric,vascular,ocular,gastro <strong>in</strong>test<strong>in</strong>al,hepato biliary,sk<strong>in</strong>, renal/ur<strong>in</strong>ary and auditory alterations. There are cases <strong>of</strong> sudden hear<strong>in</strong>g loss,S<strong>in</strong>oneural loss <strong>in</strong> the high frequencies, otosclerosis and progressive hear<strong>in</strong>g loss.Previous studies (Denger<strong>in</strong>k, Denger<strong>in</strong>k,Swanson, Thompson and Chermak,1984; Petiot and Parrot,1984), women us<strong>in</strong>g oral contraceptives were observedtoexhibit significantly greater TTS than men and normal cycl<strong>in</strong>g (NC) women. The majority<strong>of</strong> Women us<strong>in</strong>g oralcontraceptives (OC) suggested that progesterone may play a role <strong>in</strong>mediat<strong>in</strong>g the effects <strong>of</strong> noise on hear<strong>in</strong>g. Progesterone elevates basal body temperature(Tyler and Woodall, 1982; Ward, Stone and Sandman, 1978), which reflects an<strong>in</strong>crease <strong>in</strong> metabolic rate that may hasten fatigue <strong>of</strong> noise stimulated auditory structures(Henry, 1980; Law and Pettigrew, 1980; Shaddoek, Hammernik and Axelsson,1984). Further, progesterone and estrogen both appear to mediate blood pressure andcochlear blood flow changes <strong>in</strong> response to vasoactive compounds (Laugel, Denger<strong>in</strong>k,and Wright, 1987).Vestibular alterations like t<strong>in</strong>nitus vertigo and dizz<strong>in</strong>ess may appear because theseare depends on the <strong>in</strong>tegrity <strong>of</strong> the vestibular system. The use <strong>of</strong> oral contraceptives canprovoke functional alterations <strong>in</strong> the <strong>in</strong>ner ear, specially t<strong>in</strong>nitus and Irritative PeripheralVestibular Syndrome <strong>in</strong> the risk group; but auditory threshold alterations were not evident.Comb<strong>in</strong>ed estrogen and progesterone pills (contraceptive pills), taken orally for aperiod <strong>of</strong> three weeks have anovulatory action, prevent<strong>in</strong>g fertilization from tak<strong>in</strong>g place.This occurs through gonadotroph<strong>in</strong> secretion <strong>in</strong>hibition by the pituitary act<strong>in</strong>g on thehypothalamus. The progesterone agent present <strong>in</strong> the pill suppresses LH secretion andthe estrogen agent is responsible for the FSH secretion suppression, show<strong>in</strong>g a synergiceffect. Besides, the estrogen component enhances the action <strong>of</strong> the progesterone agents,117
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Verma Rekha and Parvez RaziaINTRODU
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- Page 99 and 100: Pradeep Kumar, S.S. SengarREFERENCE
- Page 101 and 102: Avantika Pandey, Natasha Nageswaran
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- Page 105 and 106: Avantika Pandey, Natasha Nageswaran
- Page 107 and 108: Aradhana Irene Charan, Nishant Kuma
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