Celso-Ramon Garcia, M.D., moderator, Sheldon Segal, M.D., pro oral contraceptives, and Louis Lasagna, M.D., cautious on oral contraceptives, discuss this therapy in a round-table, studio setting. Two discussants and a moderator present positive and negative views on the use of oral contraceptives. In their favor, one out of every three American women of childbearing age is using them with apparently very little risk. They are easy, convenient, and contribute to the overall health of the woman. Unabated population growth is slowed. Metabolic changes cease when the drug is stopped. Their use decreases the number of abortions performed, the number of undesirable marriages, and the amount of unacceptable parentalbehavior. They are almost 100% effective. The drawbacks to the use of oral contraceptives are that they affect many parts of the body, can cause depression, skin and hair changes, libido alteration, liver changes, and severe migraine. Studies indicate a strong warning of thrombo-embolic disease especially in older women. There is also the fear that they may contribute to the development of breast and genital tract cancers, although data is lacking. Other methods are not quite as effective, but are safer. They should not be taken off the market but should not be the method of first choice for all women. In summary, the risks do not appear to be great, but epidemiologic studies must continue. The drug must be used under strict supervision and labeling instructions rigidly adhered to. In relative risk versus relative advantage, there is much evidence for the continued use of oral contraceptives.
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Celso-Ramon Garcia, Louis Lasagna, Sheldon Segal.
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