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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The overall risk of oral contraceptive (OC) use is minimal when women over 35 years of age, smokers, and those with multiple risk factors (thromboembolic disorders, cerebrovascular or coronary artery disease, liver tumors, breast cancer, estrogen-dependent neoplasms, undiagnosed abnormal genital bleeding, and congenital hyperlipidemia) are excluded. OC use increases the risk of hypertension by 1-5%, depending on age, parity, and duration of use, but even this small risk is decreased when multiphasic OCs are prescribed. Deep venous thrombosis in the leg is 4 times more prevalent in OC users than nonusers and the risk of superficial thrombosis is doubled. Again, fewer thromboembolic complications occur when the estrogen dosage is low. The risk of myocardial infarction is not believed to increase with OC use as long as other risk factors--smoking, obesity, hypertension, age over 35 years, hypercholesterolemia--are not present. Studies involving the original high-dose OCs revealed a 3-fold increase in the risk of thrombotic stroke and a 2-fold increase in the risk of hemorrhagic stroke, but low-dose OCs appear to have no effect on the potential for stroke. The impact of OC use on breast cancer cannot yet be determined given the very long latency period of this cancer. In terms of benign breast disease, OC users have been shown to be at substantially reduced risk of lesions, fibroadenomas, and fibrocystic changes. OCs also protect women from endometrial and ovarian cancer, although the pill seems to accelerate the progression of cervical dysplasia. Other beneficial effects of OC use include reductions in the incidence of pelvic inflammatory disease, endometriosis, ectopic pregnancy, and ovarian cysts.
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PMID:Oral contraceptive pills. Part II: Potential complications and health benefits. 228 19

Certain physiological and pathological conditions in women require choice of a contraceptive method that will not aggravate the condition or exacerbate known side effects. IUDs and oral contraceptives (OCs) are not appropriate for the immediate postpartum. Low dose progestins appear best suited and can be started on the 5th day after delivery. IUDs and high dose discontinuous progestins are the best choices for the menopausal period, but contraindications to them must be respected. Contraception with a dominant progestational climate is required in case of benign breast disease. Low dose progestins may cause luteal insufficiency and low dose combined OCs may allow endogenous estradiol secretion poorly balanced by the progestin. All progestin-dominant formulations and discontinuous 19-norsteroids may be used. 19-norsteroids appear suitable for women with breast cancer because of their antiestrogenic activity. High dose progestins are advisable for women with precancerous or cancerous endometrial pathology. Estrogens should be avoided in such cases. Cervical cancer has never been proven to be hormonodependent, and at present the use of hormonal contraception in cervical dysplasia is not contraindicated except after pelvic radiation for invasive cancer. Use of the IUD has the same indications as for the general population after lesions have been treated. In cases of hyperlipidemia, low doses of continuously administered 19-norsteroids cause a decline of high density lipoprotein (HDL) cholesterol but are considered to be without longterm metabolic effects. The new progestin desogestrel does not diminish HDL cholesterol. Many cases of hyperlipidemia and hypercholesterolemia contraindicate OCs at the usual dose and require mechanical contraception, although low dose progestins may be considered. Derivatives of 17-hydroxyprogesterone are without effects on lipid metabolism but are less reliable. No contraceptive method is fully satisfactory for diabetics. Hormonal contraception is risky because of possible metabolic and vascular effects. Low dose progestins have the fewest side effects but are often poorly tolerated. IUDs are often used for diabetics despite possible increased risks of infection and failure. Hypertensive women should not use combined OCs or high-dose 19-norsteroids, but low dose progestins carry no risk of hypertension. Women at vascular risk are advised to use IUDs if no specific contraindications are found. Otherwise low-dose progestins are an acceptable choice. Low dose progestins are often the only possibility for cardiac patients. Nonhypertensive women with renal insufficiency can use OCs under careful supervision if there are no contraindications. Combined OCs are contraindicated when there is any disturbance of hepatic function, but low dose progestins or mechanical means are acceptable. Chronic use of certain drugs which act as enzymatic inductors is incompatible with hormonal contraception.
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PMID:[Contraception at risk]. 365 96