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THE COMBINED ORAL CONTRACEPTIV PILL AND THE RISK OF CANCER

If you are on the combined OCP you have less chance of developing cancer of the ovary and uterus and this protective effect lasts for approximately fifteen years after coming off the pill.
You will also have less chance of non-cancerous (benign) breast lumps. The effect of this pill upon your risk of breast cancer is not so clear and may vary depending upon the age at which you started the pill and for how long you took it.
The Harvard University study of over 120,000 nurses aged 30 to 55 published in the Journal of the National Cancer Institute found no link between the use of the combined OCP and breast cancer, even in cases where this pill was taken for an extended time. Studies of women aged less than 45 who had used the pill before the age of 25 have shown an increasing relative risk of breast cancer with years of pill use, especially in women who have never given birth. Two European studies have found an increased risk of breast cancer in women who started the pill at an early age, but the United States Federal Drug Administration believes that existing evidence does not support a change in prescription and use of the combined OCP.
More research is needed to determine the risk of breast cancer associated with combined OCP use at a young age because women who have taken the pill when young are only now reaching the age where the breast cancer risk is highest. This research should also examine the interaction of the pill with diet, exercise and lifestyle factors in determining its long term effects upon cancer.
Young women should be told that there may be a slightly increased risk of breast cancer from long-term use of the combined OCP, if they are to give valid informed consent when making choices in their method of contraception.
The effect of the combined OCP upon cancer of the cervix also needs more research as one study has shown an increased incidence in women on the OCP, especially after ten years' use, but cause and effect has not been proven. Thus, it is most important that all women on the OCP have regular annual pap smears.
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TAKING ESTROGEN

With the onset of menopause, many women suffer from hot flashes and night sweats. Arlene March, 56, a Los Angeles psychotherapist, says she started getting hot flashes 5 years ago. “I’d be working,” she recalls, “and suddenly feel intense heat all over my body. I’d break out in a sweat. I’d have to stop work. Then Dr. Mishell prescribed estrogen pills, and I’ve not had a day of discomfort.”
Some women experience a drying and thinning of vaginal tissues in the absence of estrogen, making sex painful. They also might suffer urinary tract infections and incontinence. Estrogen therapy often helps.
Among the physicians consulted, the most cautious was Dr. Morris Notelovitz, founder of the nation’s first Menopause Center, at the University of Florida, and head of the Women’s Medical and Diagnostic Center in Gainesville, Florida. He says each symptom needs a different treatment and advises that genital tract problems be given estrogen treatment for a couple of years at most. He also urges special measurements of the bones before prescribing estrogen therapy for osteoporosis.
*11/266/5*
WOMEN’S HEALTH

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