Download PDF
Methods Inf Med 1993; 32(03): 222-224
DOI: 10.1055/s-0038-1634914
Original Article
Schattauer GmbH

Benefits and Risks of Combined Oral Contraceptives[1]

M. P. Vessey
1   Department of Public Health and Primary Care, Radcliffe Infirmary, Oxford, U. K
› Author Affiliations
Further Information

Publication History

Publication Date:
06 February 2018 (online)

    Permissions and Reprints

Abstract:

The use of combined oral contraceptives carries a number of well-established major non-contraceptive benefits. Of these, the most important protective effects are suppression of the risk of epithelial cancer of the ovary and cancer of the endometrium. Also of great importance is a reduction in the risk of pelvic inflammatory disease. Needless to say, there are also some established risks of combined oral contraceptives. The most important of these are the vascular ones, comprising effects on acute myocardial infarction, thrombotic stroke, haemorrhagic stroke, and venous thrombosis and embolism. Possible risks which are still under evaluation include an adverse effect on breast cancer and, likewise, on carcinoma of the cervix. More information is needed about both these conditions. A number of authors have provided analyses of varying degrees of complexity in which they have attempted to weigh the benefits and risks of combined oral contraceptives. Results from some of these studies are presented in the paper. On the whole, the findings are reasonably reassuring.

Key-words

Oral Contraceptives - Epidemiological Studies - Risk/Benefit Analyses - Cancer - Vascular Disease

1 Parts of this paper are based closely on material included in an article by the author: “An overview of the benefits and risks of combined oral contraceptives”, in a book, entitled Oral Contraceptives and Breast Cancer (R. D. Mann, editor) published in 1990 by Parthenon Publishing, London, on behalf of the Royal Society of Medicine, London.


 

  • REFERENCES

  • 1 Brown S, Vessey M, Stratton I. The influence of method of contraception and cigarette smoking on menstrual patterns. Br J Obstet Gynecol 1988; 95: 905-10.
    CrossrefPubMedGoogle Scholar
  • 2 Zadeh JA, Karabus CD, Fielding J. Haemoglobin concentration and other values in women using an intrauterine device or taking corticosteroid contraceptive pills. Br Med J 1967; 04: 708-11.
    CrossrefPubMedGoogle Scholar
  • 3 Brinton LA, Vessey M, Flavel R, Yeates D. Risk factors for benign breast disease. Am J Epidemiol 1981; 113: 203-14.
    CrossrefPubMedGoogle Scholar
  • 4 Berkowitz GS, Kelsey JL, Livolsi VA. et al. Oral contraceptive use and fibrocystic breast disease among pre- and postmenopausal women. Am J Epidemiol 1984; 120: 87-96.
    CrossrefPubMedGoogle Scholar
  • 5 Rubin GL, Ory HW, Layde PE. Oral contraceptives and pelvic inflammatory disease. Am J Obstet Gynecol 1982; 144: 630-5.
    CrossrefPubMedGoogle Scholar
  • 6 Washington AE, Gove S, Schachter J, Sweet RL. Oral contraceptives, Chlamydia trachomatis, infection and pelvic inflammatory disease. JAMA 1985; 253: 2246-50.
    CrossrefPubMedGoogle Scholar
  • 7 Vessey MP, Metcalfe A, Wells C. et al. Ovarian neoplasms, functional ovarian cysts and oral contraceptives. Br Med J 1987; 294: 1518-20.
    CrossrefPubMedGoogle Scholar
  • 8 Vessey MP. Oral contraception and cancer. In: Filshie M, Guillebaud J. eds. Contraception: Science and Practice. London: Butter-worths; 1989: 52-68.
    Google Scholar
  • 9 Vessey MP, Villard-Mackintosh L, McPherson K, Yeates D. Thyroid disorders and oral contraceptives. Br J Fam Planning 1987; 13: 124-7.
    PubMedGoogle Scholar
  • 10 Vessey MP, Villard-Mackintosh L, Yeates D. Oral contraceptives, cigarette smoking and other factors in relation to arthritis. Contraception 1987; 35: 457-64.
    CrossrefPubMedGoogle Scholar
  • 11 Vessey MP, Villard-Mackintosh L, Painter R. Oral contraceptives and pregnancy in relation to peptic ulcer. Contraception 1992; 48: 349-57.
    PubMedGoogle Scholar
  • 12 Ross RK, Pike MC, Vessey MP, Bull D, Yeates D, Casagrande JT. Risk factors for uterine fibroids: reduced risk associated with oral contraceptives. Br Med J 1986; 293: 359-62.
    CrossrefPubMedGoogle Scholar
  • 13 Lloyd T, Buchanan JR, Ursino Gr. et al. Long-term oral contraceptive use does not affect trabecular bone density. Am J Obstet Gynecol 1989; 160: 402-4.
    CrossrefPubMedGoogle Scholar
  • 14 Thorogood M, Mann J, Murphy M, Vessey MP. Is oral contraceptive use still associated with an increased risk of fatal myocardial infarction? Report of a case-control study. Br J Obstet Gynaecol 1991; PS: 1245-53.
    PubMedGoogle Scholar
  • 15 Thorogood M, Mann J, Murphy M, Vessey MP. Risk factors for fatal venous thromboembolism in young women: a case-control study. Int J Epidemiol 1992; 21: 48-52.
    CrossrefPubMedGoogle Scholar
  • 16 Thorogood M, Mann J, Murphy M, Vessey M. Fatal stroke and use of oral contraceptives: findings from a case-control study. Am J Epidemiol 1992; 136: 35-45.
    CrossrefPubMedGoogle Scholar
  • 17 Rooks JB, Ory JW, Ishak KG. et al. The Cooperative Liver Tumor Study Group. Epidemiology of hepatocellular adenoma. The role of oral contraceptive use. JAMA 1979; 242: 644-8.
    PubMedGoogle Scholar
  • 18 Neuberger J, Forman D, Doll R, Williams R. Oral contraceptives and hepatocellular carcinoma. Br Med J 1986; 292: 1355-7.
    CrossrefPubMedGoogle Scholar
  • 19 Vessey MP, Smith MA, Yeates D. Return of fertility after discontinuation of oral contraceptives: influence of age and parity. Br J Fam Planning 1986; 11: 120-4.
    PubMedGoogle Scholar
  • 20 Layde PM, Vessey MP, Yeates D. Risk factors for gall-bladder disease: a cohort study of young women attending family planning clinics. J Epidemiol & Comm Hlth 1982; 36: 274-8.
    PubMedGoogle Scholar
  • 21 Vessey M, Jewell D, Smith A, Yeates D, McPherson K. Chronic inflammatory bowel disease, cigarette smoking, and use of oral contraceptives: findings in a large cohort study of women of childbearing age. Br Med J 1986; 292: 1101-3.
    CrossrefPubMedGoogle Scholar
  • 22 Anonymous. Do oral contraceptives increase the risk of contracting HIV?. Contraceptive Technology Update 1988; 09: 145-8.
    PubMedGoogle Scholar
  • 23 Tietze C, Bongaarts J, Schearer B. Mortality associated with the control of fertility. Fam Plann Perspectives 1976; 08: 6-14.
    PubMedGoogle Scholar
  • 24 Ory HW, Forrest HD, Lincoln R. Making Choices: Evaluating the Health Risks and Benefits of Birth Control Methods. New York: Alan Guttmacher; 1983
    Google Scholar
  • 25 Vessey MP. The Jephcott Lecture, 1989. An overview of the benefits and risks of combined oral contraceptives. In: Mann RD. ed. Oral Contraceptives and Breast Cancer. Carnforth; Parthenon Publishing; 1989: 121-32.
    Google Scholar
  • 26 Vessey MP, Villard-Mackintosh L, McPherson K, Yeates D. Mortality among oral contraceptive users: 20 year follow-up of women in a cohort study. Br Med J 1989; 299: 1487-91.
    CrossrefPubMedGoogle Scholar