Contraceptive preparations with a high content of estrogen (75 mcg or more) were prohibited in Sweden in 1974 whereupon the number of reported side effects of the pill markedly declined, both relatively and absolutely. The investigation, which compares the side effects reported during the period 1966-70 when the high dose preparation was on sale and 1974-78 after its prohibition. The decrease in the estrogen content took effect at that time. The risks remain, especially an excess morbidity from thromboembolism among women who use pills. While the risk increases with advancing age, the role played by the pill in the genesis of arterial complications is nonetheless slight. The risk of cardiac infarct among pill users who also smoke is not assessed in this material.
The well-described influence of several aspects of reproductive life on the risk for cancer in the reproductive organs has raised concern regarding the safety of exogenous hormones, particularly since sex hormones have become one of the most widely used drugs among women in the western world. The major areas of application include oral contraception and hormone replacement therapy in women with menopausal symptoms. Since the introduction of oral contraceptives onto the Nordic market in the late 1960s, the number of users has grown steadily, to reach proportions of long-term users among women aged 15-45 years in 1985 ranging between 6% (Norway) and 19% (Sweden) and proportions of current users in 1994 ranging between 20% (Norway) and 28% (Sweden). Such data on the current and long-term use of oral contraceptives by the female populations, linked with relative estimates of adverse (cancers of the breast and uterine cervix) and beneficial effects (protection against cancers of the ovary and endometrium), indicate that 95 cases of breast cancer and 40 of cervical cancer will be caused by oral contraceptives annually around 2000 in the Nordic countries, which corresponds to 0.6% of all breast cancers and approximately 3% of all cervical cancers. The beneficial effects include an annual prevention around the year 2000 of approximately 350 cases of ovarian cancer and a similar number of endometrial cancer, for a total about 700 cancer cases annually. The prevalence of long-term users (> or = 5 years) of hormone replacement therapy among Nordic women aged 40-69 in 1995 was estimated to be 10-11%, which on the basis of an associated relative risk for breast cancer ranging from 1.2-1.5 suggests than an annual total of 260 cases of breast cancer could be avoided in the Nordic countries around the year 2000 if hormone replacement therapy were eliminated. This corresponds to 1.8% of all notified cases of breast cancer among women in these countries.
The purpose of this study was to identify barriers to the use of oral contraceptives by ethnic Chinese women presenting for abortion. Using a qualitative descriptive study design, 40 ethnic Chinese women presenting for abortion were recruited. Data were collected in semi-structured interviews by one interviewer who is fluent in English, Mandarin, and Cantonese. Transcribed interviews were systematically analyzed to identify salient themes. The attitudes toward oral contraceptives were mostly negative. The most common fears were about weight gain, permanent infertility, and being considered "bad" (promiscuous). These mostly negative attitudes toward oral contraceptives appear to be barriers to their use.
Sixty-four young adults (aged 16 to 40 years) with ischemic stroke were analyzed in retrospect with regard to possible pathogenetic mechanisms. In older patients various predisposing factors emerge (arterial hypertension, hyperlipidemia etc.) which are rare among younger age groups. In patients lacking predisposing causes the stroke incidence exhibits a seasonal variation. It is suggested that infection may be important for the development of ischemic stroke.