Oral Contraceptives The Good News

Barbara S. Hulka, MD, MPH
JAMA. 1983;249(12):1624-1625. doi:10.1001/jama.1983.03330360064039.
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After 20 years of marketing in the United States, sufficient time has elapsed to evaluate the possibility of long-term adverse and beneficial effects of oral contraceptives (OCs). As pharmacologic agents, their early complications have been studied intensively. The cardiovascular complications were established in Britain within eight years of their market introduction and widespread acceptance.1 These adverse effects appeared somewhat less devastating when balanced in perspective with the risks associated with pregnancy and delivery. Before age 35 years, pregnancy- and delivery-related mortality exceeded mortality from OC use by more than tenfold. However, the picture was not complete in the minds of many. There lingered a concern that the steroid hormone composition of OCs would increase the frequency of cancer after enough time had elapsed. How long is enough is always uncertain. Some exposures have been associated with an increased risk of specific cancer types within five years. More commonly, 15


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