Use of oral contraceptives and smoking among Danish women
Obel, E.B.
Ugeskrift for Laeger 155(44): 3537
1993
ISSN/ISBN: 0041-5782 PMID: 8236573 Document Number: 405261
Oral contraceptive (OC) pills have a very high rate of acceptability among Danish women in spite of the possible risks associated with their use referred to in the daily press. Every fourth woman prefers OCs. Half of the women under 25 use OCs as well as every tenth one over 35. There is hardly any doubt that the use of OCs can increase the risk of blood clot in the heart, and the more cigarettes are smoked the higher the risk. Today increasing doses of gestagens are used with minor effect on the lipid system. The risk of deep venous thrombosis of the lower extremities and the risk of cerebral thrombosis or embolism is elevated even with low-dose OCs, but regarding cerebral thrombosis, research is inconclusive. The risk of cerebral thrombosis is very low among young women and it increases with age. Considering that masses of young women use OCs, and increased incidence of breast cancer has been found under 45 years of age among those who had used OCs before the birth of their first child, a risk that seems to correspond to perhaps a higher number of breast cancer cases in the following years. This can be explained by the fact that OC users do not have an increased risk of breast cancer, but may undergo checkups more often than others, giving a higher chance of early diagnosis of this disease. Based on this it would be unwise to advise against OCs for women under 25, but the issue has to be examined in the context of the risks of other contraceptive methods and AIDS. It is reasonable to restrict OC use in women over 35-40 who smoke more than 5-10 cigarettes daily, or who have other known risk factors for cardiovascular disease.