Hormonally Active Contraceptives Part I: Risks Acknowledged and Unacknowledged

Area of Science:

• Reproductive Health
• Pharmacovigilance
• Women's Health

Background:

• Hormonal contraceptives have been widely used for over 50 years, with evolving formulations but consistent mechanisms of action.
• Numerous studies have documented both immediate and long-term side effects impacting women's health and quality of life.

Purpose of the Study:

• To conduct comprehensive literature surveys to understand the immediate and long-term side effects of hormonal contraceptives.
• To identify side effects that are often unacknowledged or not fully disclosed in prescribing information.

Main Methods:

• Systematic review and comprehensive literature surveys of studies on hormonal contraceptive side effects.
• Analysis of documented side effects, comparing them with information provided in prescribing materials.

Main Results:

• Identified numerous potential side effects, including increased HIV transmission risk with depot medroxyprogesterone acetate (DMPA).
• Unacknowledged risks for combination contraceptives include breast and cervical cancer, inflammatory bowel disease, lupus, multiple sclerosis, depression, mood disorders, suicides, and osteoporotic bone fractures.
• Noted misleading information regarding cardiovascular and thrombotic risks, and identified fatty weight gain and female sexual dysfunction as potential side effects.

Conclusions:

• Women have a right to be fully informed about all potential risks associated with hormonal contraceptives.
• Effective nonhormonal methods, such as fertility awareness methods, offer risk avoidance strategies.
• The continued marketing of DMPA is unjustified due to demonstrated unique risks and the availability of safer alternatives.