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  • Title: [Oral and intrauterine contraception. Use and adverse effects].
    Author: Gram LF, Kovács I, Pedersen A.
    Journal: Ugeskr Laeger; 1976 May 03; 138(19):1133-9. PubMed ID: 1265912.
    Abstract:
    In 1973 oral contraceptives were used by 30% of all women aged 15-45. Between 1973 and 1975 the number of women using oral contraceptives decreased by 40%, while in the same period the number of women using IUDs increased from 60,000 to 100,000 and the monthly number of induced abortions rose from 1100 to 2300. During 1972-1975 the number of women using induced abortion as a method of contraception rose from about 7000 to about 14000. The increase in the use of these 2 forms of intrauterine contraception thus corresponds to the decrease in the use of oral contraception. These changes, attributable in part to exaggerated reports in the press on side effects of contraception, do not appear to have affected the birthrate. Changes also occurred in the pattern of consumption of different types of oral contraceptives. There has been a gradual decrease in the sale of high-estrogen pills, which constituted 76% of the total consumption of oral contraceptives in 1968 and 21% in October 1974, when their sale for contraceptive use was stopped. The sale of low-estrogen preparations increased until 1973, then dropped somewhat. The sale of mini-pills increased steadily until mid-1974, then declined. The increase in the use of IUDs during 1974 was lamost entirely due to the introduction of Gravigard and Copper T-Kabi. The incidence of thromboembolic disease as related to sales has been consistently higher in association with use of high estrogens than low estrogens over the 7-year period. During the 3 years since the introduction of minipills only on incident of thromboembolic disease has been reported. The annual number of deaths from complications during pregnancy, abortion, birth and puerperium decreased until 1962-1964, after which a rise began; oral contraceptives were introduced in 1966. The most frequently reported side effect from the use of mini-pills and IUDs was unwanted pregnancy, which was 20-30 times greater for mini-pills than for high-estrogen pills. 2 cases of uterine perforation were reported from use of Dalkon Shield and Gravigard. According to the literature, widespread use of oral contraceptives is associated with a reduced number of deaths related to pregnancy, abortion, birth and puerperium. As, however, such mortality has decreased rapidly over the past decades and had become insignificant by 1970, any possible bearing the decrease in consumption of oral contraceptives might have on mortality would be difficult to assess.
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