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Oral contraception: past, present, and future perspectives.

¹Department of Obstetrics and Gynecology, University of Southern California, School of Medicine, Los Angeles.

International Journal of Fertility

|January 11, 1992

Summary

Low-dose oral contraceptives (OCs) maintain contraceptive efficacy while offering improved health benefits for healthy, nonsmoking women. These formulations present a safer option, reducing risks associated with older, higher-dose OCs.

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Area of Science:

Reproductive Health
Endocrinology
Pharmacology

Background:

Oral contraceptives (OCs) have been available since 1960, with initial formulations containing higher doses of estrogen and progestogen.
Formulations have evolved to include sequential estrogen, daily progestogen, and variable doses of both hormones.

Observation:

Modern OCs utilize significantly lower estrogen and progestogen doses compared to earlier versions.
Estrogen impacts lipid profiles (HDL, LDL) and serum globulin concentrations.
Progestogens can induce insulin resistance, alter lipid profiles, and cause androgenic effects.

Findings:

Lower-dose OCs preserve excellent contraceptive efficacy.
Estrogen and progestogen doses in current OCs are markedly lower than in 1960s/1970s formulations.
No increased risk of myocardial infarction or stroke in healthy, nonsmoking women using OCs with <50 mcg estrogen.
Low-dose OCs have neutral effects on glucose and lipoprotein metabolism.
Noncontraceptive health benefits are maintained with lower-dose formulations.

Implications:

Low-dose oral contraceptives offer a safer profile for healthy, nonsmoking women.
These formulations can improve overall health while preventing unwanted pregnancy.
Reduced hormonal doses minimize metabolic and thrombotic risks, particularly for younger, non-smoking women.

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