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  • Title: The misunderstood pill: thirty years of testing and development have reduced pill's major, minor side effects.
    Author: United States. Centers for Disease Control CDC. Advisory Committee on Immunization Practices.
    Journal: Netw Res Triangle Park N C; 1986; 7(4):1-5. PubMed ID: 12341093.
    Abstract:
    Many users of oral contraceptives (OCs) and potential users misunderstand the risks and benefits of OCs. A recent poll in the US revealed that 3 out of 4 women thought the pill carried substantial health risks. Nearly 2/3 of the women surveyed believe using OCs is at least as risky as childbearing. Family Health International (FHI) recently conducted a world survey of perceptions of OCs. It shows that women in many other countries share US womens negative image of the pill. Women believe in pill-related dangers scientists have never even suspected, much less proven, such as an increased risk of stomach cancer. Yet, many women, especially women in developing countries, are unaware of problems such as cardiovascular disease that are related to OC use, and they are ignorant of the proven health benefits of OCs, such as protection against ovarian and endometrial cancer. Despite the persistence of negative perceptions of the pill, research conducted over the past 30 years has shown that the pill is safe for the great majority of women and, in fact, provides significant health benefits for many users. With the contraceptive effectiveness of the pill established through the early tests, drug companies began steadily lowering the hormone dosages. By 1983, more than half of the OCs sold in the US contained less than 0.5 mg estrogen. Many of the combination OCs now sold have only 0.2 to 0.4 mg estrogen. Eventually, pill researchers learned that OCs containing only progestogen, even in comparatively small doses, also could effectively prevent pregnancy, though not as effectively as pills containing estrogen. The first progestogen-only pills received US Food and Drug Administration approval in 1973. Continued research on OCs shows that the increased risks of cardiovascular diseases actually were almost entirely confined to specific groups women who were over 35 or who both were over 30 and smoked. For the great majority of women, studies showed, the risk of cardiovascular disease was increased little by OC use. FHI's recent study of long-term OC risks and benefits, based on previous epidemiological research, demonstrates that OC use has no net effect on life expectancy for most women. Among younger women who do not smoke, life expectancy is slightly increased by OC use, the study shows. This is because OCs provide protection against ovarian and endometrial cancer. In an effort to improve compliance with recommended OC procedures, FHI has initiated a series of studies which will examine the interaction between OC side effects, the information and support given OC users by family planning providers, and OC compliance.
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