Oral contraceptives reduce death rate

The overall death rate is reduced among women who used high-dose oral contraceptives (OC) in the 1970s and 1980s, according to findings from the Oxford Family Planning Association contraceptive investigation. In contrast, the lethal effects of smoking are already apparent among women by the age of 35 to 44.Researchers at the University of Oxford research group had recruited 17,032 women from family planning clinics in England and Scotland between 1968 and 1974. At enrolment, the subjects were between the ages of 25 and 39, were married and had been using the OC pill, a diaphragm or an intrauterine device for at least 5 months. OC pills usually contained 50 µg oestrogen. There were a total of 899 deaths among these women by 2000. The rate of death from any cause was 11% lower among OC users compared with nonusers. For smokers, the death rate was increased by 24% for those who smoked 1 to 14 cigarettes per day at recruitment, and by more than 100% among heavier smokers. Among heavy smokers, the increased risk of death was apparent even in women ages 35 to 44. So it is not as though the adverse effects are reserved for the elderly. Among women age 55 and older, the increased risk of death attributable to heavy smoking was even higher.The death rate from cervical cancer was much higher among OC users than among non-users. However, the beneficial effects (of OC use) on ovarian and other uterine cancers more than outweigh the effects on cervical cancer. The report indicates that OC use appeared to increase the risk of fatal heart disease, but the association was small and not significant. In fact, the increased risk of heart disease associated with OC use was confined to smokers. There was no harmful effect of oral contraceptive use on overall mortality. By contrast, death from all causes was more than twice as high in smokers. This study can be used to discourage smoking and to give women increased confidence in the safety of oral contraception.