Combined oral contraceptives: health benefits beyond contraception

Panminerva Med. 2014 Sep;56(3):233-44.

Abstract

It has been recognized for over 50 years that combined oral contraceptives (COCs) are also capable of offering health benefits beyond contraception through the treatment and prevention of several gynaecological and medical disorders. During the last years a constant attention was given to the adverse effects of COCs, whereas their non-contraceptive benefits were underestimated. To date, most women are still unaware of the therapeutic uses of hormonal contraceptives, while on the contrary there is an extensive and constantly increasing of these non-contraceptive health benefits. This review summarizes the conditions of special interest for physicians, including dysmenorrhoea, menorrhagia, hyperandrogenism (acne, hirsutism, polycystic ovary syndrome), functional ovarian cysts, endometriosis, premenstrual syndrome, myomas, pelvic inflammatory disease, bone mineral density, benign breast disease and endometrial/ovarian and colorectal cancer. The benefits of COCs in rheumatoid arthritis, multiple sclerosis, menstrual migraine and in perimenopause have also been treated for more comprehensive information. Using COCs specifically for non-contraceptive indications is still outside the product licence in the majority of cases. We strongly believe that these aspects are not of minor relevance and they deserve a special consideration by health providers and by the mass media, which have the main responsibility in the diffusion of scientific information. Thus, counseling and education are necessary to help women make well-informed health-care decisions and it is also crucial to increase awareness among general practitioners and gynaecologists.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris / drug therapy
  • Arthritis, Rheumatoid / drug therapy
  • Bone Density / drug effects
  • Breast Diseases / drug therapy
  • Colorectal Neoplasms / drug therapy
  • Contraception / methods
  • Contraceptives, Oral, Combined / therapeutic use*
  • Endometrial Neoplasms / drug therapy
  • Endometriosis / drug therapy
  • Female
  • Hirsutism / drug therapy
  • Humans
  • Migraine Disorders / drug therapy
  • Multiple Sclerosis / drug therapy
  • Myoma / drug therapy
  • Ovarian Cysts / drug therapy
  • Ovarian Neoplasms / drug therapy
  • Pelvic Inflammatory Disease / drug therapy
  • Perimenopause
  • Polycystic Ovary Syndrome / drug therapy
  • Premenstrual Syndrome / drug therapy

Substances

  • Contraceptives, Oral, Combined