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 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Women throughout the world and throughout time have ingested substances such as mercury, diluted copper ore, and various noxious solutions in the mistaken belief that these substances would prevent pregnancy. The era of modern contraception began in 1937 with the discovery that the administration of progesterone could halt ovulation in rabbits. During the next decade, work proceeded on finding an easy and less expensive way to synthesize progesterone and to develop the synthetic estrogens mestranol and ethinyl estradiol. Initial trials in humans proved that these hormones could prevent ovulation. In 1950, with support from Margaret Sanger and Katharine Dexter McCormick, Gregory Goodwin Pincus developed the first oral contraceptive (OC), which consisted of supplemental progestin and 0.5 mg norethindrone. In the early 1990s, the Ortho Pharmaceutical Corporation introduced an OC that combined the synthetic progesterone norgestimate and 35 mcg of ethinyl estradiol. By 1988, several noncontracepting health benefits of the OC were recognized, including decreased rates of ovarian cancer, endometrial cancer, pelvic inflammatory disease, ovarian cysts, benign breast disease, iron deficiency anemia, and dysmenorrhea. These health benefits outweigh risks even in nonsmoking women over 40. In the US, 80% of women have used the OC at one time, and they are using this most popular form of reversible contraception longer than ever.
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PMID:A history of oral contraception: from evolution to revolution. 767 Apr 17

Dr. David Grimes, professor and vice-chair of the Department of Obstetrics/Gynecology and Reproductive Sciences, University of California at San Francisco, spoke to the American Medical Association's Thirteenth Annual Science Reporters Conference in Seattle on November 7, concerning the health benefits of taking oral contraceptives. The risk of getting ovarian cancer decreases the longer the pill is used; this protection lasts at least 15 years after use has ended. Women who take the pill for a decade or longer reduce their risk of developing this cancer by 80%. The pill reduces the risk of endometrial cancer by as much as 50%; the protection is strongest in those at highest risk and lasts at least 15 years after use. The pill cuts the risk of pelvic inflammatory disease in half. The danger of ectopic or tubal pregnancy is reduced by 90%. By reducing menstrual flows, oral contraceptives increase the quality of life for women and reduce the risk of iron deficiency anemia. The progestin present in oral contraceptives substantially reduces the risk of benign breast disease. Oral contraceptives may protect against toxic shock syndrome, rheumatoid arthritis, and osteoporosis. A Gallup poll conducted in 1985 and early this year indicates gross misinformation and confusion about the pill among American women. While the pill should not be "pushed" on women by physicians, patients should be educated about the beneficial effects of taking the pill.
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PMID:Report: the pill's health benefits appear to far outweigh its risks. 789 51

Few guidelines exist for the use of estrogen, particularly low-dose oral contraceptives, during the perimenopausal years. Use of low-dose oral contraceptive pills in women over 35 years of age provides protection against unwanted pregnancy, maintains a stable hormonal environment and decreases abnormal menstrual bleeding. Other noncontraceptive health benefits of oral contraceptives include a reduction in bone loss and protection against iron deficiency anemia, dysmenorrhea, benign breast disease, endometrial cancer and epithelial ovarian cancer. This article discusses potential risks of oral contraceptive use in this age group, as well as recommendations about when and how to change from contraceptive therapy to postmenopausal hormone replacement therapy.
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PMID:Oral contraceptive use during the perimenopausal years. 980 1

This article reviews several different articles which have contributed to an understanding of the harmful or beneficial effects of oral contraceptives (OCs) on various diseases. The Royal College of General Practitioners study found that current OC users compared to women who had never used OCs had relative risks of .52 for menorrhagia, .37 for dysmenorrhea, .65 for irregular cycles, .72 for intermenstrual bleeding, and .71 for premenstrual syndrome. Several studies found combined OCs to offer protection against ovarian cysts. Microdose progestin only pills did not ameliorate most menstrual problems and aggravated ovarian cysts. Despite some theoretical grounds for suspecting an association between pituitary prolactinomas and OC use, recent studies have failed to find an increased relative risk for prolactinomas in women using OCs for contraceptive purposes, although 1 study found an increased risk in women using OCs for cycle control. 1 study reported 11 pregnancies in 30 diabetic women in 15 months of IUD use; the high rate was attributed to abnormal patterns of mineral deposit on the IUD surface. The 11 pregnancies occurred with 5 Gravigardes, 5 Saf-T-Coils, and 1 Dalkon Shield. Other studies on the contrary have noted no difference in pregnancy rates among 103 diabetic women using Copper Ts or 118 diabetic women using Lippes loops. Combined OCs appear to reduce the incidence of rheumatoid arthritis by 1/2 among current OC users and to protect former users as well. Combined OCs aggravate lupus erythmatous but synthetic progestins alone are effective without aggravating the condition. It has recently been argued that low dose OCs are not contraindicated in cases of sickle cell disease and may even offer protection against thromboembolic vascular accidents for women with sickle cell anemia. Estimates of relative risk of pelvic infection among IUD users vary from 1.5 to 6.5, with the risk apparently greatest for women under 25. Recent studies have indicated that copper IUDs do not have the bactericidal power formerly attributed to them. Numerous in vitro studies and statistical comparisons of the effect of spermicides in vivo have demonstrated that local methods provide protection against sexually transmitted diseases. OCs may favor vaginal infection, but some recent studies have indicated that they offer protection against pelvic infections. The protective effect of the condom against sexually transmitted diseases is well known. It has been estimated that, relative to non-users of OCs, each 100,000 users will have 235 fewer cases of benign breast disease, 35 fewer of ovarian cysts, 320 fewer of iron deficiency anemia, 600 fewer of pelivc infection, 117 fewer of extrauterine pregnancy, 32 fewer of rheumatoid arthritis, 1 fewer of endometrial cancer, and 3 fewer of ovarian cancer.
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PMID:[Disease and contraception. Recent aspects]. 1228 Feb 11

Oral contraceptives (OCs) remain the leading choice of reversible contraception for American women. In the 1999 Contraceptive Technology Update Contraceptive survey, more than 60% of the providers say that 50 or more women leave their offices each month with pill prescriptions in hand. Of the available OCs in the market, a 20-mcg Alesse pill and 20- and 30-mcg Loestrin pills are the top choices among older nonsmoking women because they help them through the perimenopausal stage. Among younger nonsmoking women, the 35-mcg Ortho Tri-Cyclen pill is the top choice because it is effective, leads to few complications and side effects, and has easy-to-use packaging. Research has established that OCs protect women against dysmenorrhea and menorrhagia, menstrual cycle irregularities, iron deficiency anemia, ectopic pregnancy, pelvic inflammatory disease, ovarian cysts, benign breast cancer disease, endometrial cancer, and ovarian cancer. Aside from the noncontraceptive health benefits, OCs have proven valuable in the management of a variety of gynecologic disorders. Providers are moving toward prescription of OCs specifically for noncontraceptive benefits, but respondents are still unwilling to see OCs offered as over-the-counter drugs.
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PMID:Pills remain the top choice among reversible contraceptive options. 1229 Mar 80

Progestins in oral contraceptives (OCs) produce potential complications, as well as noncontraceptive benefits, according to Robert A. Hatcher, MD, MPH, professor of gynecology and obstetrics, Emory University Medical School. Hatcher told CTU that lowering the progestin content in an OC may decrease complications, but could also decrease the benefits experienced by women. "The extent to which that will happen remains to be seen," he said. Hatcher cited the following potential complications of progestins in OC: hypertension; decreased levels of high density lipoproteins; acne; oily skin; headaches between pill cycles; dilated leg veins; pelvic congestion syndrome; thrombosis of superficial leg veins; gallstones; Monilia vaginitis; cholestatic jaundice; and depression, fatigue, and decreased libido. Progestins, according to Hatcher, also produce these noncontraceptive benefits: protection against PID; decreased dysmenorrhea; decreased menstrual blood loss, decreased iron deficiency anemia; protection against endometrial cancer; protection against fibrocystic breast disease, and fibroadenomas of the breast; decreased bleeding from fibroids; decreased growth of fibroids. When ovulation is suppressed, Hatcher emphasized, additional benefits that may occur include the following: decreased risk of functional ovarian cysts; elimination of mittleschmerz pain; decreased rick of ovarian cancer; protection against endometriosis.
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PMID:Potential risks, benefits of progestins in birth control pills outlined. 1231 83

The use of oral contraceptives (OC) by an estimated 150 million women worldwide has prompted concern about their potential risks. But, there are also health conditions--medical and surgical disorders, reproductive tract cancers, and menstruation disorders--that oral contraceptives affect beneficially. OC users have a lower risk of iron deficiency anemia, an important consideration for nutritionally deficient women. The risk of developing pelvic inflammatory disease is also decreased in OC users, as is the risk of ectopic pregnancy. This is important for women in developing countries, where access to medical services for a life-threatening ectopic pregnancy might be limited. Using OCs lowers the incidence of surgery for benign breast disease, the incidence of retention cysts of the ovary, the risk of endometrial cancer, the risk of epithelial ovarian cancer, and relieves symptoms of dysmenorrhea and premenstrual syndrome. The risks associated with OC use, including stroke and heart attack, vary among age groups, smoking status, and other cardiovascular risk factors. For example, elevated serum cholesterol is lower among women in developing countries, so the associated risk of heart attack is lower for these women. Other complications associated with OC use are deep-vein thrombosis, pulmonary embolism, gallbladder disease, and hepatic adenoma. There is controversy about whether OC use increases the risk of cervical neoplasia. Studies that have attempted to define this risk are subject to methodological problems, in that increased surveillance of OC users results in a higher rate of detection. Some controversy exists about OC use and an increased risk of breast cancer, but no definitive results are available. Although the risks associated with OC use can be serious, these risks are only slightly higher among OC users compared with non-users. The benefits, such as reduced risk of serious diseases and gynecological disorders, seem to outweigh the risks, pointing to the need for accurate communication between health professionals and the women they advise about contraceptive choices.
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PMID:Beyond contraception: the health benefits and risks of the pill. 1231 33

Each year as a consequence of pregnancy and delivery at least 500,000 women die, 99% of them in developing countries. Most maternal deaths are avoidable. For each death, 10-15 other women suffer serious health effects which may lead to chronic pain or even social isolation. Childbirth is riskier for women who are too young or too old, who have many children, or whose births are too closely spaced. Limiting family size reduces both maternal and child deaths. In developed countries, 5-30 women die per 100,000 births, compared to 50-800 in developing countries. Maternal mortality rates at 2 hospitals in Yaounde, Cameroon, have declined significantly in recent years, probably due to establishment of high risk pregnancy clinics, improved monitoring during labor, and child spacing clinics. Improved obstetric services and child spacing could reduce maternal mortality in developing countries as they have in the developed world. The use of contraception has been a controversial topic in traditional African societies, but by now the majority of governments of developing countries include family planning programs in their development plans for their health as well as their economic benefits. Despite gradual increases, fewer than 5% of women in most African countries use modern contraception. African men play an insignificant role in family planning. The continuing practices of prolonged lactation and postpartum abstinence in rural areas have compensated to some extent for the absence of modern contraception. Oral contraceptives are the most widely used reversible method. They may protect against vaginal infection, iron deficiency anemia, ectopic pregnancy, benign breast disease, ovarian and endometrial cancer, dysmenorrhea, endometriosis, and rheumatoid arthritis. There is evidence that some steroid hormones have a beneficial effect in stabilizing the cellular membranes of red blood cells in women with sickle cell anemia. The danger of infection with the IUD is largely limited to the 1st 4 months of use and to women with sexually transmitted diseases. Careful selection of candidates, aseptic insertion, and regular follow-up are needed to ensure IUD safety. The IUD is contraindicated for nulliparas. Barrier methods provide contraception as well as some protection against sexually transmitted diseases. Condoms have a significant protective effect against HIV infection. Diaphragms, cervical caps, and vaginal sponges provide some protection against infections like gonorrhea and chlamydiae that invade the cervical cells. Many adolescents resist condoms because they diminish sensation. But condoms provide protection against sexually transmitted diseases and are appropriate for individuals with sporadic sex lives. Oral contraceptives are more effective but adolescents are at risk of forgetting pills. IUDs are the least attractive option for adolescents because of the danger of infection and subsequent infertility.
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PMID:[High risk pregnancies and family planning]. 1234 59

Combined oral contraceptives (OCs), especially the current low-dose formulations, provide significant noncontraceptive benefits. They bring about an overall improvement in health. Some physicians are interested in prescribing OCs to premenopausal women at an early age, even if they are not at risk for unwanted pregnancy, to protect these women from developing 2 fatal cancers. Even though this is not currently the standard of care, much data provide justification to seriously consider prescribing OCs to premenopausal women. Ever use of OCs reduces the risk of ovarian cancer by 40-80% and the risk of endometrial cancer by 40-60%. Ovarian cancer and endometrial cancer are the 4th and 7th leading causes of death among US women, respectively. The protective effect against both cancers is associated with duration of OC use and continues for many years after OC use ceases. OC use also reduces the risk of pelvic inflammatory disease (PID), from which about 1 million US women suffer each year. It decreases the incidence of hospitalization for PID by about 50%. OC use also protects against functional ovarian cysts, iron deficiency anemia, and benign breast disease. It appears that use of OCs for at least 6 years increases bone density and thus reduces the risk of hip fractures in later life. OC use may also protect against disabling rheumatoid arthritis. On the other hand, there is some evidence that OCs may be associated with breast cancer, but the epidemiologic data are inconsistent. A thorough analysis of the risk-benefit ratio using available data should be conducted to weigh the noncontraceptive benefits of early or long-term OC use with the risks.
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PMID:Expanded role for OCs. Question and answer. 1234 76

Smoking is dangerous for all women, regardless of the method of contraception used. Women who smoke and take the oral contraceptive pill should stop smoking, since the combined effect of smoking and oral contraception may increase a woman's risk of heart attack compared to smoking only. Since women under age 35 who smoke and use the pill are at greater risk of death from pregnancy and childbirth than from using the pill, smoking and not oral pill use should be eliminated from their lives in the interest of practicing a safe and highly effective mode of birth control. Pill use is definitely not recommended for women aged 35 and older who smoke. Many programs exist to help one stop smoking. Stopping smoking is very important to reduce one's risk of stroke whether or not the pill is being used. Exactly how much the pill may or may not increase a woman's risk of getting a blood clot is controversial, although blood clots among otherwise healthy pill users who do not smoke are rare. In addition to being a very safe method of birth control which is highly effective when taken correctly and consistently, birth control pill use protects women against ovarian cancer, endometrial cancer, painful or irregular periods, breast cysts, iron deficiency anemia, ectopic or tubal pregnancy, and infections of the fallopian tube requiring hospitalization. Healthy, nonsmoking women can safely take the pill right up until menopause.
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PMID:The truth about oral contraceptives, heart attack, stroke and blood clots. 1234 1


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