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Menlo Park, California, Henry J. Kaiser Family Foundation, 1996 Jan 31.  p.This series of tables illustrates findings from the Kaiser Family Foundation's 1996 National (US) Survey on Public Perceptions about Contraception. Pie charts show that 43% of women aged 18-44 (women of reproductive age [WRA]) and 39% of all Americans believe that oral contraceptives (OCs) are somewhat safe and an additional 25 and 17%, respectively, believe OCs are very safe. The charts indicate that 61% of WRA and 44% of all Americans cite potential health risks as their primary safety concerns (20 and 24%, respectively, cite lack of protection against disease, and 20 and 7%, respectively, doubt the contraceptive efficacy of OCs). Most WRA (58%) believe that OCs have no effect on the likelihood of developing osteoporosis, but only 41% believe that chances of acquiring breast cancer are unaffected by OC use (32% believe chances are heightened). Most WRA (57%) believe that OCs increase chances of blood clots, and only 16% believe that OC use reduces chances of developing ovarian cancer. Nearly half (47%) of the WRA believe that women's chances of getting heart disease are not affected by OC use. WRA receive most of their contraceptive information from physicians (88%), nurses (75%), family/friends (60%), television (48%), magazines (43%), advertisements (41%), and printed media (40%). Among WRA who have ever used OCs, 53% reported that their partner had no influence in their decision to use this method (19% reported that their partner had a lot of influence). Most men (76%) whose current or most recent partner used OCs reported that their partner had a lot of influence in this decision.
JOURNAL OF THE FLORIDA MEDICAL ASSOCIATION. 1986 Oct; 73(10):763-8.The increase in safety and public confidence in oral contraceptives (OCs) stems essentially from 3 factors: the availability of lower dose OCs, a better identification of risk factors, and more public awareness of noncontraceptive health benefits associated with OC use. The combination OC, used by 99% of women using OCs, continues to contain estrogen and progesterone in synthetic form, but the dosages and formulations have changed, giving the new pill a wider margin of safety. The OCs of today contain 1/5 the estrogen and 1/10 the progesterone as in the original OCs. During the decade of the 1980s, with estrogen dosage as low as therapeutically possible, medical research has shifted toward a more thorough evaluation of the progesterone component. In 1974 the Royal College of General Practitioners Study found a correlation between progesterone dosage and the frequency of high blood pressure developing in OC users. Subsequent studies reported that high blood pressure, which was likely to develop in about 5% of OC users on higher dose pill, will revert to normal when OC use is stopped. Additional research has linked pills containing progesterone in high dosages to elevations in blood sugar and blood cholesterol. Since progesterone dosage has declined from 10 milligrams in the original pill to 1 milligram or less in current formulations, there appears to be a wide margin of safety for most healthy young women using OCs. In the mid-1980s, further research on OCs has become more fine tuned with greater emphasis on how different types and combinations of hormones influence side effects and safety. The most recent development has been the introduction of "multiphasics" or sometimes called "triphasics." Multiphasic pills are basically low dose pills which vary hormone dosage in each of 3 separate phases in an effort to roughly simulate changes that would occur in a normal menstrual cycle. A better understanding of risk factors has increased markedly the margin of safety for women considering OC use. The report of the Alan Guttmacher Institute, "Making Choices," revealed that if women over 35 or who smoked did not use OCs, 86% of the approximately 500 pill-related deaths that occurred each year could be prevented. The Guttmacher report also attempted to quantify health benefits and risks to provide a more accurate overall picture of OC effects. Table 1 shows that many more hospitalizations are prevented than are caused by OC use. Among hospitalizations prevented, most were for benign breast disease, pelvic inflammatory disease, ectopic pregnancy, ovarian cysts, ovarian cancer, and endometrial cancer. No evidence has linked defects or miscarriages to pregnancies conceived immediately after stopping OC use. The overall fertility of OC users and non-OC users is identical regardless of how long a woman uses OCs. A lack of consistent health education programs in the public schools has contributed in some instances to misinformation about OC and other contraceptive methods.