The Pill: A Closer Look

Abstract

This article summarizes the major risks and benefits of oral contraceptive (OC) use for specific categories of users. Major risks associated with OC use include vascular and circulatory disorders, hypertension, cancer, and other conditions such as gallbladder disease. There are also numerous minor side effects, e.g., breast tenderness, weight changes, yeast infections. Most of these side effects are attributed either to estrogen or progestin, which mimic excesses or deficiencies in the natural hormonal balance. These symptoms can often be reversed through alterations in the hormonal content of the OC. There have been numerous recent reports regarding the protective effect of OC use against conditions such as benign breast disease, ovarian and endometrial cancer, pelvic inflammatory disease, ectopic pregnancy, and rheumatoid disease. The risks and benefits for potential users can only be evaluated through reference to data from the relevant population group, taking into account factors such as age, race, heredity, potential predisposition for disease, and social habits. Information about the risk of medical problems in specific population groups must be weighed against the risk for those problems in the same population when combined with OC treatment. The benefits of the drug must also be weighed against the number and degree of risks found for the specific user. The convenience and efficacy associated with OCs can far outweigh the risks, inconveniences, and less impressive efficacy of other contraceptive methods in many cases. However, women over age 35 years, especially smokers, should use alternative methods of contraception. New hormonal contraceptive formulations and different modes of drug delivery are currently under development. However, several years of scientific investigation will be required to evaluate the longterm advantages or disadvantages of the newer experimental drugs compared with present OCs.