Current perspectives on oral contraceptive use

Oral contraceptives are one of the most highly effective forms of contracep tion and provide many short- and long-term noncontraceptive health benefits . They control menstrual cycle irregularities, such as breakthrough bleedin g and amenorrhea, and are effective in treating dysfunctional uterine bleed ing. In addition, for decades after oral contraceptive use is discontinued they are associated with substantial decreases in the risk of ovarian cance r (up to 80%) and of endometrial cancer (40%-50%), and nearly eliminate ben ign functional ovarian cysts. Long-term oral contraceptive use confers prot ection against benign breast disease and colorectal cancer, may help preven t rheumatoid arthritis, decreases ectopic pregnancy and hospitalizations fo r pelvic inflammatory disease, and helps preserve bone mineral density to r educe risk of fractures. Large bodies of evidence from extensive research h ave clarified the perceived association of oral contraceptive use with card iovascular disease and with breast cancer. Findings indicate that there is no increased risk of myocardial infarction or stroke associated with oral c ontraceptive use in healthy, nonsmoking, normotensive women. Although there is a 3- to 4-fold increased risk of venous thromboembolism with current or al contraceptive use, the absolute risk is very small and is half that asso ciated with pregnancy. Women of all reproductive ages, including perimenopa usal women, can realize many health benefits through oral contraceptive use , including improved health status later in fife.