Pros and Against of hormonal contraception
Abstract
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.
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