Many benefits of the contraceptive pill are recognized in healthy women: regular cycles, without heavy
bleeding, without dysmenorrhea and without premenstrual syndrome. But the contraceptive pill can
be used for specific therapeutic objectives: treatment of polycystic ovaries, endometriosis, vaginal
bleeding disorders and in long term acne, seborrhea, hirsutism and alopecia therapy (contraceptive pills
containing ethinyl estradiol and a progestogen with antiandrogenic activity). There is still scientific evidence that the contraceptive pill reduces the risk of appearance of tumors or cysts in the ovary or
endometrium.
However the contraceptive pill also has its risks. These being dependent on the dose, it is estimated
that in modern low-dose oral contraceptives, they are much less frequent and intense than in the early
days of their marketing, but do not fail to manifest themselves. The most common are those that lead
to a decrease in physical and / or psychological well-being of women. There is also some scientific
evidence that hormonal contraceptives may be involved in the onset / development of benign liver
tumors as well as increased risk of gallstones. But the most serious adverse effects are cardiovascular
effects: increased risk of thromboembolic disease, onset / worsening of hypertension, dyslipidaemia and
glucose intolerance, and the consequent increased risk of cardiovascular disease. Finally, the literature
refers that hormonal contraceptives increase the risk of developing certain cancers, especially in the
cervix and breast.
As with any drug, the risk-benefit ratio must always be taken into account when prescribing one
contraceptive pill, and the principle of therapeutic individualization should be based on scientific and
clinical but also personal and socio-economic criteria. Also in regard to contraception we should follow
evidence-based medicine: use all the scientific information and make it available to the woman so that
she, in the biopsychosocial context in which it appears, can make an informed decision regarding her
fertility.
Keywords: Contraception, dyslipidemias, evidence-based medicine
full txt in Portugal:
Acta Farmacêutica Portuguesa 2014, vol. 3, n. 2, pp. 113-123
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