Noncontraceptive clinical benefits of oral contraceptives

The contraceptive benefits of oral contraceptives have become well known since the introduction of this birth control method in the 1960s. Since that time, a more sophisticated understanding of the hormonal components of the medication has developed, along with reduction in the dosages of these hormones. During the past decade in particular, the medical literature has documented a number of noncontraceptive benefits delineated by studies conducted in Europe and the United States. Users of oral contraceptives have reduced rates of both endometrial and ovarian cancer, and this protection persists even when oral contraceptive use is discontinued. The risk of ectopic pregnancy is reduced up to tenfold among oral contraceptive users and the risk of pelvic inflammatory disease (salpingitis), two- to fourfold. The necessity for performing surgical excision of benign breast cysts or functional ovarian cysts is substantially reduced in women who take oral contraceptives. There also is evidence that the risk of rheumatoid arthritis is reduced in oral contraceptive users. Finally, women who take oral contraceptives have less menstrual dysfunction, such as menorrhagia and dysmenorrhea, than do nonusers. In the United States, it has been estimated that as many as 50,000 hospital admissions are prevented annually because of the noncontraceptive benefits of these drugs. Accordingly, these benefits should be taken into account when discussing contraceptive methods with patients.