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Fam Plann Perspect. 1989 Nov-Dec;21(6):273-4.

Reconsidering the age limits on pill use.

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The Alan Guttmacher Institute.



This article reports on an advisory committee of the US Food and Drug Administration (FDA) which recommended the removal of age limits on the use of oral contraceptives by healthy nonsmoking women. The factors that weighed on this "judgement call" which is unusual for the FDA were: previous studies that set an upper age limit for nonsmoking women of 40 years were done in the mid-1970's with high dose oral contraceptives which are a much higher health risk than today's low dose pills; women older than 40 often choose sterilization and the committee felt that their decision was affected by the lack of highly effective alternatives; the ability to conceive is a very real possibility for women 35-49 (e.g. 86% for women age 35-39, 78% for ages 40-44, and 69% for ages 45-49), and pregnancy for this age group is believed to be much more dangerous than the low dose pill's health risk. The committee did consider evidence of the pill's implications in increasing breast cancer and cervical cancer but found the data inconclusive or not an added health burden when considering the potential health benefits of a lowered risk of ovarian and endometrial cancer. The FDA committee urges further research on the risks and benefits or oral contraception. The evidence of increased risk of cardiovascular disease from pill use among smoking women, especially those over 40, was incontrovertible and the committee adhered to an upper age limit of 35 years for using oral contraceptives for smoking women.

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