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Safety concerns and health benefits associated with oral contraception

  • Ronald Burkman
    Correspondence
    Reprint requests: Ronald Burkman, MD, Baystate Medical Center, Department of Obstetrics and Gynecology, 759 Chestnut St, Springfield, MA 01199.
    Affiliations
    Department of Obstetrics/Gynecology, Baystate Medical Center,a Springfield, Mass; Division of Biostatistics, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Fox Cancer Research,b Miami, Fla; Family Planning, Department of Obstetrics and Gynecology, Emory University School of Medicine,c Atlanta, Ga USA
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  • James J. Schlesselman
    Affiliations
    Department of Obstetrics/Gynecology, Baystate Medical Center,a Springfield, Mass; Division of Biostatistics, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Fox Cancer Research,b Miami, Fla; Family Planning, Department of Obstetrics and Gynecology, Emory University School of Medicine,c Atlanta, Ga USA
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  • Miriam Zieman
    Affiliations
    Department of Obstetrics/Gynecology, Baystate Medical Center,a Springfield, Mass; Division of Biostatistics, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Fox Cancer Research,b Miami, Fla; Family Planning, Department of Obstetrics and Gynecology, Emory University School of Medicine,c Atlanta, Ga USA
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      Abstract

      Since the introduction of hormonal contraceptives in the 1960s, there have been a variety of both health benefits and safety concerns attributed to their use. In most instances, the noncontraceptive benefits of oral contraceptives (OCs) outweigh the potential cardiovascular risks. In fact, the probability of a patient experiencing a cardiovascular event while taking a low-dose OC is very low. However, smoking, hypertension, obesity, and diabetes are risk factors that must be taken into account when prescribing OCs. The neoplastic effects of hormonal contraceptives have been extensively studied, and recent meta-analyses indicate that there is a reduction in the risk of endometrial and ovarian cancer, a possible small increase in the risk for breast and cervical cancer, and an increased risk of liver cancer. Finally, many women will experience noncontraceptive health benefits with OCs that expand far beyond pregnancy prevention. Some of these benefits include reduction in menstrual-related symptoms, fewer ectopic pregnancies, a possible increase in bone density, and possible protection against pelvic inflammatory disease.

      Keywords

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