Combined progestin and estrogen (oral), and other forms of hormonal contraception

This review examines controversies concerning serious side effects of oral contraceptives. Current concerns about the pill are with either relatively small excess risks or with very long-term effects, which need not be small. The main outstanding questions are the effects on cardiovascular disease of lowering doses and the effects on breast cancer of oral contraceptive use at a young age. In the end, the possible effects on breast cancer incidence cause the most concern. It is argued that most epidemiologic studies are too small to reliably detect effects among particular subgroups and it is possibly too soon to know what the long-term effects of using oral contraceptives while young on breast cancer actually are. However, complacency is contraindicated.