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Hormonal contraception--what kind, when, and for whom?
Inka Wiegratz1, Christian J Thaler
1Klinik für Frauenheilkunde und Geburtshilfe, Schwerpunkt Gynäkologische Endokrinologie und Reproduktionsmedizin, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Frankfurt am Main, Germany. Inka.Wiegratz@kgu.de
Deutsches Arzteblatt International
|August 5, 2011
Summary
Combined oral contraceptives (COCs) are a safe and effective birth control method for women when risk factors are considered. While they carry some risks, COCs also offer significant protection against certain cancers.
Area of Science:
- Reproductive Health
- Gynecology
- Pharmacology
Background:
- Combined oral contraceptives (COCs) are widely used by women of child-bearing age in Germany.
- Alternative long-acting contraceptives exist but are less common due to side effects like breakthrough bleeding.
Purpose of the Study:
- To review the mode of action, side effects, and long-term risks of COCs.
- To compare COC efficacy and usage with other contraceptive methods.
Main Methods:
- A selective review of existing medical literature was conducted.
Main Results:
- COCs prevent pregnancy by suppressing ovulation, with low failure rates (0.3-1 per 100 women/year).
- They impact cardiovascular and hemostatic systems, and metabolism, increasing risks for cardiovascular disease and thromboembolism in susceptible individuals.
- COCs are associated with an increased risk of cervical cancer in HPV-infected women but reduce the incidence of endometrial, ovarian, and colorectal cancers.
Conclusions:
- COCs are a safe, reversible, and well-tolerated contraceptive option when individual and family risk factors are carefully assessed.
- The benefits, including cancer risk reduction, must be weighed against potential risks.
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