Risk factors for uterine fibroids: reduced risk associated with oral contraceptives: Authors' reply

Abstract

As far as we can ascertain the presence of has not been regarded as a contraindication to oral contraceptive (OC) use in Britain although some authorities suggest that women who are taking the pill should be kept under observation. Caution is however also counselled about the use of IUDs in women so any patient selection is likely to have operated in relation to this birth control method as well; as we noted in our paper there was no relationship use of an IUD and in our study. Perhaps more importantly all women giving a history of on recruitment to our study were excluded from the analysis (not just those pathologically confirmed as incorrectly stated in our paper). 2 further points seem worth making. Firstly the fact that we found that the protective effect of OCs against increased duration of use argues against selection bias being the explanation. Secondly a substantial number of women in our study 1st started to use OCs during the follow up period having switched from a diaphragm or an IUD. We found no evidence to suggest that OCs are likely to provoke fibroid complications either in the early months of use or later. In our view Dr. Ratners hypothesis does not offer an explanation for our findings. We would like to take this opportunity to point out a number of typographical errors in the article as printed: on page 360 column 2 line 4 from bottom of page should have read with either 0.25 mg or 0.15 mg levonorgestrel brands; in table 4 the drug name in the 2nd column should have been lynestrenol not lynestrol; and on page 361 column 1 line 5 from bottom of page should have read: between cervicitis and fibroids not between urinary tract infections and fibroids. (full text)