Contraception (Birth Control) and Family Planning PubHealthInfo

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PubHealth.info® (a subsidiary of PakMed) presents scientific information mainly based on abstracts of articles published on a variety of public health issues/topics, particularly encompassing population planning, disease prevention, maternal and child health, and communicable and non-communicable diseases (like HIV AIDS, malaria, etc) that are affecting a significant portion of population in developing and developed countries. Here you can find abstracts of articles published on a variety of public health topics under category "Contraception (Birth Control) and Family Planning". Contraception (birth control) is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant or giving birth. Therefore contraception is the utilization of various and sundry surgical procedures, devices, practices, agents, or drugs with the intention of preventing conception or impregnation (pregnancy). Methods and intentions typically termed birth control may be considered a pivotal ingredient to family planning. Birth control is a controversial political and ethical issue in many cultures and religions, and although it is generally less controversial than abortion specifically.

YEAR: 1983

CATEGORY: Contraception (Birth Control) and Family Planning

TITLE

Oral contraceptive hazards--reappraisal.

AUTHORS

Goldzieher JW

SOURCE

In: Chaudhuri SK. Practice of fertility control: a comprehensive textbook.

Calcutta, India, Current Book Publishers, 1983. :108-114.

ABSTRACT

Certain critical issues in relation to the risks of oral contraceptives (OCs) now demand renewed inspection. Both

case/control and prospective studies have indicated a 4-6 fold "relative risk" of OC use associated with

thromboembolic disease. 2 pivotal publications have changed the entire aspect of the thrombophlebitis question.

By the use of modern, definitive diagnostic techniques it has been shown that the clinical diagnosis of

thromboembolic disease is subject to an enormous degree of error. Using I125 fibrinogen, Hicks (1972)

demonstrated that not more than 20-40% of deep leg vein thrombosis is evident clinically. Barnes et al. (1978)

examined thromboembolic disease by the use of Doppler ultrasound. In patients hospitalized for thromboembolic

disease who were not on OCs, the clinical diagnosis was found to be in error in 69%. In patients known to be on

OCs, the diagnosis was in error in 83%. Similar conclusions regarding misdiagnosis have been reached with

respect to pulmonary embolism (Robin, 1977). Under these circumstances, it follows that none of the

epidemiological studies have been provided with acceptably reliable information and that none of the conclusions

can be considered valid. One is forced to conclude that there is simply no reliable information on the association of

thromboembolic disease and OC use. The entire subject will have to be reassessed in accurately diagnosed cases

and evaluated with sufficiently rigorous epidemiological procedures. The widely quoted British studies on

myocardial infarction are also not without their major problems. The 1st epidemiological study (Mann and Inman,

1976) of mortality from this condition examined half the death certificates and concluded that the "relative risk" in

women under age 40 was 2.8 and that for women aged 40-44 was 4.7, a finding that resulted in the recommendation

that older women not use OCs. As the numbers involved in the 1st analysis were small, the other half of the death

certificates for this age group were examined. In this 2nd half of the sample, there was no risk associated with OC

use, but the reappraisal received virtually no attention from the medical profession and no rectification appeared in

the public information media. Data on myocardial infarction morbidity from the same investigators have fared even

worse. The British prospective studies have also been interpreted as showing an increased cardiovascular hazard.

With cardiologic rather than epidemiological insight, it is difficult to find OCs as the common denominator in these

cases. Inspection of the small number of deaths in the Royal College of General Practitioners study is similarly

unimpressive. (PubHealth.info Document ID: CONT5T 2069-06)

PubHealth.info NOTE: The author(s) of this article titled, "Oral contraceptive hazards--reappraisal.", is(are)

Goldzieher JW. The source of this article is "In: Chaudhuri SK. Practice of fertility control: a comprehensive textbook.

Calcutta, India, Current Book Publishers, 1983. :108-114.". This article was published in 1983 in English

language(s). (PubHealth.info® Document ID: CONT5T 2069-06. All rights reserved with PubHealth.info) PIN: 22069

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