| Abstract: | Until recently it appeared as if oral contraception greatly reduced the costs of fertility control. The advantages of effectiveness and the convenience of this method in preference to coitus-related contraception led to the dramatic increase in oral contraceptive (OC) use during the 1960s in the U.S. The trend in the 1970s is different. OC use has leveled off, and suspicions have arisen that the net costs to women of using this form of birth control are higher than was previously believed. Discontinuation rates by women who have been on OCs have increased despite major improvement in the chemistry of the OC in recent years. In view of the evidence concerning the apparent risks to health associated with OCs, the current trend is not surprising. The range of major diseases for which the relative risk is higher among OC users seems to be broadening, and, as a consequence, the cumulative absolute risk overall of these diseases may be very much higher than was believed when only selected thromboembolic entities seemed to be involved. In order to obtain the public's view about the safety of OCs, 1500 voting age adults have been questioned in national surveys since 1966. 34% of the respondents in 1976 said that they believed the OC to be safe, but 47% of this group meant that it is as safe as aspirin. 34% ranked it as being somewhat less safe than aspirin. Their answers indicate that over time there had been increasing anxiety about the safety of the OC, but no general sense of panic. Even among those who felt it is unsafe, only a minority are willing to label it as "really dangerous." |
