Hormonal Contraceptives Offer Benefits Beyond Pregnancy Prevention
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Hormonal contraceptives are effective in treating menstruation- related disorders such as dysmenorrhea and heavy menstrual bleeding, as well as preventing unplanned pregnancies, according to a new Practice Bulletin issued today by The American College of Obstetricians and Gynecologists (ACOG) and published in the January 2010 issue of Obstetrics & Gynecology. In addition, combined contraceptives containing both estrogen and progesterone offer disease prevention by reducing the risk of developing endometrial, ovarian cancer, and colorectal cancer.
More than 80% of women in the US will use some form of hormonal contraception during their reproductive years. There are several different forms of hormonal contraception including pills, patches, implants, injections, vaginal rings, and the intrauterine device (IUD). Pregnancy prevention is the primary reason that most women use hormonal contraception. However, these contraceptives are also frequently prescribed specifically for non-contraceptive reasons, which is considered off-label use.
"We've known for many years that hormonal contraceptives have health advantages beyond preventing pregnancy," says Robert L. Reid, MD, of Kingston, Ontario, who led development of the document. "These recommendations examine the scientific data supporting the non-contraceptive uses of hormonal contraceptives to treat specific conditions."
For instance, both oral contraceptives and the single-rod progestin implant help relieve or reduce the symptoms of dysmenorrhea (severe menstrual pain), the most commonly reported menstrual disorder. Dysmenorrhea affects up to 90% of young women and is a leading cause of women missing school and work. A variety of hormonal contraceptives are also useful in treating menorrhagia (excessive menstrual bleeding), which, if left untreated, can lead to anemia. All forms of birth control that contain both estrogen and progesterone have the potential to improve hirsutism (excess hair growth) and acne because they suppress production of the male hormone, androgen. Other potential benefits of hormonal contraceptives include prevention of menstrual migraines, treatment of pelvic pain due to endometriosis, and treatment of bleeding due to uterine fibroids.
"Combined oral contraceptives are effective in normalizing irregular periods, reducing symptoms of premenstrual dysphoric disorder, improving acne, and allowing women to avoid having their period at inconvenient times, such as during a business trip, vacation, or honeymoon ," says Dr. Reid. "Although there is little data on the newer forms of hormonal contraception in terms of their off-label benefits, experts suggest that they may be as effective as the more studied ones in treating the same conditions."
The scientific evidence shows that the longer a woman uses the birth control pill, the lower her risk for developing endometrial and ovarian cancer later, up to 20 years after discontinuing use. The pill also seems to offer some short-term protection against colorectal cancer among current or recent users.
Practice Bulletin #109, "Non-contraceptive Uses of Hormonal Contraception," is published in the January 2010 issue of Obstetrics & Gynecology.
American College of Obstetricians and Gynecologists (ACOG)
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