[Disease and contraception. Recent aspects]

Contracept Fertil Sex (Paris). 1985 Jan;13(1 Suppl):431-6.
[Article in French]

Abstract

PIP: This article reviews several different articles which have contributed to an understanding of the harmful or beneficial effects of oral contraceptives (OCs) on various diseases. The Royal College of General Practitioners study found that current OC users compared to women who had never used OCs had relative risks of .52 for menorrhagia, .37 for dysmenorrhea, .65 for irregular cycles, .72 for intermenstrual bleeding, and .71 for premenstrual syndrome. Several studies found combined OCs to offer protection against ovarian cysts. Microdose progestin only pills did not ameliorate most menstrual problems and aggravated ovarian cysts. Despite some theoretical grounds for suspecting an association between pituitary prolactinomas and OC use, recent studies have failed to find an increased relative risk for prolactinomas in women using OCs for contraceptive purposes, although 1 study found an increased risk in women using OCs for cycle control. 1 study reported 11 pregnancies in 30 diabetic women in 15 months of IUD use; the high rate was attributed to abnormal patterns of mineral deposit on the IUD surface. The 11 pregnancies occurred with 5 Gravigardes, 5 Saf-T-Coils, and 1 Dalkon Shield. Other studies on the contrary have noted no difference in pregnancy rates among 103 diabetic women using Copper Ts or 118 diabetic women using Lippes loops. Combined OCs appear to reduce the incidence of rheumatoid arthritis by 1/2 among current OC users and to protect former users as well. Combined OCs aggravate lupus erythmatous but synthetic progestins alone are effective without aggravating the condition. It has recently been argued that low dose OCs are not contraindicated in cases of sickle cell disease and may even offer protection against thromboembolic vascular accidents for women with sickle cell anemia. Estimates of relative risk of pelvic infection among IUD users vary from 1.5 to 6.5, with the risk apparently greatest for women under 25. Recent studies have indicated that copper IUDs do not have the bactericidal power formerly attributed to them. Numerous in vitro studies and statistical comparisons of the effect of spermicides in vivo have demonstrated that local methods provide protection against sexually transmitted diseases. OCs may favor vaginal infection, but some recent studies have indicated that they offer protection against pelvic infections. The protective effect of the condom against sexually transmitted diseases is well known. It has been estimated that, relative to non-users of OCs, each 100,000 users will have 235 fewer cases of benign breast disease, 35 fewer of ovarian cysts, 320 fewer of iron deficiency anemia, 600 fewer of pelivc infection, 117 fewer of extrauterine pregnancy, 32 fewer of rheumatoid arthritis, 1 fewer of endometrial cancer, and 3 fewer of ovarian cancer.

MeSH terms

  • Biology
  • Blood*
  • Contraception*
  • Contraceptive Agents
  • Contraceptive Agents, Female*
  • Contraceptives, Oral*
  • Copper
  • Diabetes Mellitus*
  • Disease*
  • Dysmenorrhea
  • Endocrine Glands*
  • Endocrine System
  • Family Planning Services*
  • Genitalia
  • Genitalia, Female*
  • Infections*
  • Inorganic Chemicals
  • Intrauterine Devices*
  • Lupus Erythematosus, Systemic*
  • Menorrhagia
  • Menstruation Disturbances*
  • Metals
  • Metrorrhagia
  • Neoplasms*
  • Ovarian Cysts*
  • Ovary*
  • Pelvic Inflammatory Disease*
  • Physiology
  • Premenstrual Syndrome
  • Sexually Transmitted Diseases*
  • Spermatocidal Agents*
  • Urogenital System*

Substances

  • Contraceptive Agents
  • Contraceptive Agents, Female
  • Contraceptives, Oral
  • Inorganic Chemicals
  • Metals
  • Spermatocidal Agents
  • Copper