Health benefits of oral contraceptives

Jeffrey Jensen, L. Speroff

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

A sizeable literature corroborates the multiple health benefits of oral contraceptive use. The first estrogen/progestin combination pills were marketed to treat a variety of menstrual disorders. Although currently used oral contraceptives no longer carry FDA-approved labeling for these indications, they remain important therapeutic options for a variety of gynecologic conditions. Well-established gynecologic benefits include a reduction in dysmenorrhea and menorrhagia, iron-deficiency anemia, ectopic pregnancy, and PID. Although older, higher-dose pills reduced the incidence of ovarian cysts, low-dose pills suppress follicular activity less consistently. Nevertheless, cycle-related symptoms, including functional cysts, dysmenorrhea, chronic pelvic pain, and ovulation pain (mittelschmerz), generally improve. Women with polycystic ovary syndrome note improvement in bleeding patterns and a reduction in acne and hirsutism. Symptoms from endometriosis also improve with oral contraceptive therapy. Current data suggest that oral contraceptive therapy increases bone density and that past use decreases fracture risk. Oral contraceptives also improve acne, a major health concern of young women. Oral contraceptives provide lasting reduction in the risk of two serious gynecologic malignancies - ovarian and endometrial cancer. The data with respect to ovarian cancer are compelling enough to recommend the use of oral contraceptives to women at high risk by virtue of family history, positive carrier status of the BRCA mutations, or nulliparity, even if contraception is not required. Health care providers must counsel women regarding these benefits to counteract deeply held public attitudes and misconceptions regarding oral contraceptive use. Messages should focus on topics of interest to particular groups of women. The fact that oral contraceptives increase bone mineral density and reduce ovarian cancer is of great interest to women in their forties and helps influence use and compliance in this group. In contrast, the beneficial effects of oral contraceptives on acne resonates with younger women. Getting the good news out about the benefits of oral contraceptives will enable more women to take advantage of their positive health effects.

Original languageEnglish (US)
Pages (from-to)705-721
Number of pages17
JournalObstetrics and Gynecology Clinics of North America
Volume27
Issue number4
StatePublished - 2000

Fingerprint

Insurance Benefits
Oral Contraceptives
Acne Vulgaris
Ovarian Neoplasms
Dysmenorrhea
Bone Density
Menorrhagia
Hirsutism
Ovarian Cysts
Pelvic Pain
Iron-Deficiency Anemias
Ectopic Pregnancy
Polycystic Ovary Syndrome
Health
Progestins
Endometriosis
Risk Reduction Behavior
Endometrial Neoplasms
Ovulation
Parity

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Health benefits of oral contraceptives. / Jensen, Jeffrey; Speroff, L.

In: Obstetrics and Gynecology Clinics of North America, Vol. 27, No. 4, 2000, p. 705-721.

Research output: Contribution to journalArticle

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