Abstract

PIP: Although oral contraception (OC) offers reliable and esthetic contraception for 40-50 million women in the world today, serious complications do occur with its use and must be considered in a basic risk-benefit equation. Thorough knowledge of these complications and their predisposing factors may guide the selection of patients for OC use and management of its use. The following complications are reviewed: Vascular thrombosis (cerebrovascular disease, coronary artery disease), hypertension, carbohydrate metabolism, lipid metabolism, neoplasms (cervical tumors, breast tumors, endometrial carcinoma, benign tumors of the uterus and ovary, liver tumors), subsequent reproductive function (outcome of pregnancy), subjective effects (emotional state), gallbladder disease, liver function, and other effects. The incidence of complications may be decreased by proper prescribing and selection of patients. OC use in hypertensive or diabetic patients is not recommended. They should be used with caution in the younger obese patient and not used in the obese patient over age 35. OC may be prescribed for women over age 35 who do not smoke or have any other risk factor and who are apprised of the possible but uncertain degree of increased risk of coronary occlusion from pill use alone. Women with headaches developing or increasing with OC use should discontinue this method of contraception. It is recommended that women with any of these risk factors who have completed their desired families should be offered surgical sterilization.