Benefits and risks of oral contraceptives.
The major benefits of modern low-dose oral contraceptives include relative safety and a high degree of efficacy, decreasing the need for abortion or surgical sterilization; reduced risks of bacterial (but not viral) pelvic inflammatory disease and of endometrial and ovarian cancer; improved menstrual regularity, with less dysmenorrhea and blood flow; and, when low-dose combination (not progestogen-only) oral contraceptives are used, reduced acne and hirsutism. Major risks are cardiovascular. Preliminary data from nonrandomized studies suggest that oral contraceptives containing third-generation progestogens are associated with increased risk of venous thromboembolism, particularly in carriers of the coagulation factor V Leiden mutation. The risk of arterial thrombosis, such as myocardial infarction or stroke, may be directly related to estrogen dose, particularly in women who have hypertension, smoke, or are >35 years old. Considering that only users aged >/=30 years who smoke >/=25 cigarettes/d have a higher estimated mortality rate than that of pregnant women, the benefits of oral contraceptives appear to outweigh their risks.
Sherif
K
K
Institute for Women's Health, MCP Hahnemann University, Philadelphia, Pennsylvania, USA.
D002318:Cardiovascular Diseases / Q000139:chemically induced; D003276:Contraceptives, Oral / Q000009:adverse effects* / Q000627:therapeutic use*; D000075202:Contraindications; D004347:Drug Interactions; D005260:Female; D005831:Genital Diseases, Female / Q000517:prevention & control; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
D003276:Contraceptives, Oral