In 1987, over 13 million women of reproductive age (15 to 44 years) reported using oral contraceptives. Despite widespread use, women are still concerned about adverse effects. A 1985 Gallup poll reported that three out of four women believe that the use of birth control pills causes serious health problems, including cancer, stroke and myocardial infarction.

Mishell points out that the current scientific literature does not support the belief that the use of oral contraceptives poses a significant health risk for most healthy women of reproductive age. For example, studies have shown that the use of oral contraceptives actually decreases the risk of ovarian and uterine cancer. There is no conclusive evidence that oral contraceptives increase cancer risk, with the exception of cervical cancer, which can be more easily diagnosed and treated than other types of cancer.

Previous studies suggesting an increased risk of cardiovascular disease in oral contraceptive users were conducted among women who received formulations that contained 50 lAg or greater of estrogen. This increased risk, however, was found only among older women with preexisting risk factors, such as smoking, hypercholesterolemia, diabetes and hypertension. Recent studies of healthy women taking primarily low-dose oral contraceptives (35 [mu]g or less of estrogen) indicate that there is no increased risk of myocardial infarction or stroke. In fact, studies suggest that estrogen may have a protective effect against atherosclerosis by increasing high-density lipoprotein levels and decreasing low-density lipoprotein levels. Estrogen use also causes a modest increase in triglyceride levels.

Consumers are generally unaware of other benefits of oral contraceptives. These include reduced risk of iron deficiency anemia, corpus luteal and follicular cysts, salpingitis, dysmenorrhea and premenstrual syndrome. Premenopausal use of oral contraceptives may also provide protection against the development of postmenopausal osteoporosis.