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  • Title: Noncontraceptive health benefits and risks of steroidal contraception.
    Author: Pasquale SA.
    Journal: Int J Fertil; 1989; 34 Suppl():85-7. PubMed ID: 2576266.
    Abstract:
    From the extensive research conducted over the past 28 years, there is a clear picture that the noncontraceptive benefits of steroidal contraceptives are considerable and the benefits outweigh the risks. The risks associated with the increased incidence of thromboembolic disease have reduced with lower doses of both estrogen and progesterone. Also, the increased risk of hepatocellular carcinoma is very low, compared with the benefits. One benefit is the reduction in primary dysmenorrhea which was discovered in 1940. This occurs due to the suppression of ovulation and decrease in endometrial growth. Ovarian cysts resolve spontaneously; 3500 fewer hospitalizations due to ovarian cysts are reported for 1982. 11,000 fewer cases of ectopic pregnancy/year are a result of oral contraceptive (OC) use. Retrospective case studies have found that pelvic inflammatory disease (PID) is prevented by use of OCs. This happens because the cervical mucus remains thick throughout the menstrual cycle with OC use, and thus prevents transportation of bacteria by sperm from the lower to the upper genital tract. Another reason is the decreased amount of blood flow at the time of withdrawal provides a less conducive environment for bacteria growth. 15,000 annual hospitalizations for PID are estimated to have been prevented by OC use. The data on breast cancer are conflicting, but most do not show a link between OCs and breast cancer. In fact, benign breast disease may be reduced by 23,000 annual hospitalizations due to OC use. Another benefit of OC use is the decreased incidence of endometrial and ovarian cancer. The relative risk among OC users in 1987 was estimated at P = 0.6 for primary endometrial cancer. This beneficial effect continues after OC use is discontinued. There is a 40% reduction in the incidence of ovarian cancer among OC users compared with nonusers, and is related to duration of use, but the protective effect continues after OC use discontinuation. Bone mass is increased in women who use OCs, although further study is required to determine whether the increased bone mass protects from osteoporosis after menopause.
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