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  • Title: OCs: international experts discuss state-of-the-art.
    Journal: Contracept Technol Update; 1981 Nov; 2(11):147-51. PubMed ID: 12338027.
    Abstract:
    This article provides a state-of-the-art report on oral contraceptives (OCs). Users are continuously informed about the risks of pill ingestion but there are benefits as well. Benign breast disease, benign ovarian cysts, ectopic pregnancy, ovarian cancer, and pelvic inflammatory disease (PID) were some of the conditions which were prevented by OCs. Iron deficiency anemia, rheumatoid arthritis, and initial PID were also prevented. The protective effect of OCs against PID is the most important protective effect of OCs. Decreased menstrual cramping may be another important pill benefit. A new triphasic OC, Trinordiol, may be highly effective in reducing side effects associated with low-dose pills. It provides doses of estrogen and progestin which vary in each 1/3 of the menstrual cycle. Some other advantages are improvement in acne, dysmenorrhea, breast tension, gastrointestinal upset, and rash. While scientists do not know the exact action of the pill on the cardiovascular system, it may have an effect on clotting mechanism activators. OCs increase fibronolytic activity; the pill provides a protective mechanism against blood clotting disorders. A table is presented which illustrates the effects of age, smoking, and the pill on thrombogenic and atherogenic factors. There is discussion about the woman over age 35 as a candidate for OC usage. It may be that the minipill may be ideal. The over-35 woman may need additional counseling about the other types of contraceptive methods available. The diaphragm and the IUD are good options; sterilization is an excellent option providing the patient has obtained counseling. Recent data indicate that the minipill may be a popular form of contraception. While they do have certain side effects, there are remarkably similar patterns of use between minipill and combined pill users. According to 1 doctor, withholding OCs from 10% of current users could reduce the incidence of excess myocardial infarction by 75%. These cases are among women over 30 who also smoke.
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