title: The abuse of high dose estrogen/progestin combination drugs in delay of menstruation: the assumptions and practices of doctors, midwives and pharmacists in a Peruvian city.
abstract: The results are presented of a field study of the use of high dose Estrogen/Progestin combination drugs in Cusco, Peru, 1987. In Western countries the sale of these products is restricted. In the 1970s the use of high dose Estrogen/Progestin combination drugs as a hormonal pregnancy test was assumed to cause birth defects. Still these drugs have high sales data in Third World countries, where they are marketed for the treatment of menstrual disorders and for pregnancy diagnosis. A widespread misuse as abortifacient is assumed, although the abortive effect has never been proved. In this study 112 gynaecological consultations by doctors and 53 by midwives were observed. Seventeen health professionals and 26 salesmen in pharmacies were interviewed. It turned out that doctors and midwives prescribe high dose Estrogen/Progestin combination drugs to women whose periods are delayed. Of the consults 33% concerned this complaint. Women prefer "hindsight" birth control methods. Abortion is illegal. Under the cover of menstruation regulation or pregnancy diagnosis health professionals meet the wishes of women who search for an abortifacient. The products can easily be obtained without prescription. It is suggested that high dose Estrogen/Progestin combination drugs should be withdrawn from the market.
authors.forename: J
authors.initials: J
authors.lastname: Bonnema
authors.forename: J A
authors.initials: JA
authors.lastname: Dalebout
mesh_terms: D000019:Abortifacient Agents / Q000600:supply & distribution; D001291:Attitude of Health Personnel; D004338:Drug Combinations; D004967:Estrogens / Q000600:supply & distribution; D006801:Humans; D009721:Nurse Midwives / Q000523:psychology / Q000706:statistics & numerical data; D010568:Peru / Q000453:epidemiology; D010595:Pharmacists / Q000523:psychology / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D011364:Professional Practice / Q000706:statistics & numerical data*; D011374:Progesterone / Q000600:supply & distribution; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D000019:Abortifacient Agents; D004338:Drug Combinations; D004967:Estrogens; D011374:Progesterone