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We have studied tryptophan metabolism "via kynurenine" in women who were oral contraceptives users, living in two different egyptian environments: in the city of Alexandria or in a rural area near Tanta and, in comparison, in control groups of women living in the same environments but who were not contraceptives users. In the non contraceptives users of Tanta we have registered a higher elimination of some metabolites (anthranilic acid, kynurenic acid, xanthurenic acid and 3-OH-anthranilic acid) which might be related to the way of life and environment. The pattern of the kynurenine pathway metabolites of the contraceptives users (studied 1, 3 and 12 months after contraceptives administration) shows some differences with respect to the controls, both in the spontaneous elimination and in that after tryptophan load. These differences are especially evident for anthranilic acid glucuronide, kynurenine and kynurenic, anthranilic and xanthurenic acids. Some differences may be observed after 1 month of contraceptives administration. The effect of tryptophan oral load is superimposed on those of environment and contraceptives use; in the spontaneous elimination of tryptophan metabolites an accomodation to the contraceptives administration is evident. The discrepancies between some of our results and those of the literature might be related to the influence of environmental factors and of the way of life.

The effect upon tryptophan metabolism of the use of combined oestrogen-progestagen oral contraceptives containing a low (0.05 mg) dose of oestrogen, or of the continuous administration of megestrol acetate, has been studied by determining the excretion of tryptophan metabolites in urine collected after a 2 g oral dose of the amino acid. An investigation of 10 women before being given oral contraceptives and after 21 days and three months of their use showed that xanthurenic acid excretion is increased within 21 days and that by three months the urinary levels of xanthurenic acid, kynurenine, 3-hydroxykynurenine, and 3-hydroxyanthranilic acid may all be elevated. Ten other women studied after taking a combined type of oral contraceptive for six months or longer excreted significantly higher levels of all four metabolites than did those who had been treated with these steroids for only three months. The abnormal urinary excretion of tryptophan metabolites was completely reversed by treatment with pyridoxine hydrochloride, 20 mg daily for one month. Studies of four women when they were taking an oestrogen-containing oral contraceptive and at intervals after they had discontinued its use showed that abnormal tryptophan metabolism may persist for three months or longer. Megestrol acetate, a progestagen used as an oral contraceptive, was found to have no significant effect upon tryptophan metabolism.The possible clinical significance of the effects of oral contraceptives upon tryptophan metabolism is discussed.