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The combined oral contraceptive pill in women over age forty.
Ann Acad Med Singapore. 2003 Sep; 32(5):624-31.AA

Abstract

INTRODUCTION

By the age of 35 years, most women would have completed their families and contraception then becomes an important consideration. In the next one or two decades, other health concerns such as osteoporosis, dysfunctional uterine bleeding, ovarian, endometrial, colorectal and breast cancers and cardiovascular diseases will assume prominence in the lives of women. We review the role of the combined oral contraceptive (OC) pill in the older woman in the context of these important health concerns.

METHODS

A Medline search was made for possible interaction between OC use and the above conditions. An important criteria for citation was publication in a high impact factor journal; furthermore to represent the wider context from which there issues derive we choose, whenever appropriate, general journal with wide readership including, but not limited to the Lancet or New England Journal of Medicine; we also choose studies published in journals of other medical disciplines instead of purely gynaecological journals to reflect the multidisciplinary impact of the combined OC pills.

RESULTS

Combined OC retards bone demineralisation which could translate clinically to a reduction in postmenopausal osteoporotic fractures; it affords good menstrual cyclicity and alleviation of perimenopausal vasomotor symptoms; it offers chemoporophylaxis against epithelial ovarian cancers and endometrial cancers. There is evidence that it could be protective against colorectal cancers. The combined OC may attenuate the disease progression of rheumatoid arthritis and reduces the risk of ectopic pregnancy and pelvic inflammatory disease. In an older woman who does not smoke and is in good health, the excess risk of stroke, myocardial infarcts and venous thromboembolism is minimal, if at all, as is the risk of breast neoplasm. In women with proven human papilomavirus infection of the cervix who are using OCs, regular cervical screening is especially important.

CONCLUSION

The non-contraceptive health benefits of the combined OCs justify its usage in the healthy older woman.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, National University Hospital, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

14626790

Citation

Wong, M T., and K Singh. "The Combined Oral Contraceptive Pill in Women Over Age Forty." Annals of the Academy of Medicine, Singapore, vol. 32, no. 5, 2003, pp. 624-31.
Wong MT, Singh K. The combined oral contraceptive pill in women over age forty. Ann Acad Med Singap. 2003;32(5):624-31.
Wong, M. T., & Singh, K. (2003). The combined oral contraceptive pill in women over age forty. Annals of the Academy of Medicine, Singapore, 32(5), 624-31.
Wong MT, Singh K. The Combined Oral Contraceptive Pill in Women Over Age Forty. Ann Acad Med Singap. 2003;32(5):624-31. PubMed PMID: 14626790.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The combined oral contraceptive pill in women over age forty. AU - Wong,M T, AU - Singh,K, PY - 2003/11/25/pubmed PY - 2004/3/16/medline PY - 2003/11/25/entrez SP - 624 EP - 31 JF - Annals of the Academy of Medicine, Singapore JO - Ann. Acad. Med. Singap. VL - 32 IS - 5 N2 - INTRODUCTION: By the age of 35 years, most women would have completed their families and contraception then becomes an important consideration. In the next one or two decades, other health concerns such as osteoporosis, dysfunctional uterine bleeding, ovarian, endometrial, colorectal and breast cancers and cardiovascular diseases will assume prominence in the lives of women. We review the role of the combined oral contraceptive (OC) pill in the older woman in the context of these important health concerns. METHODS: A Medline search was made for possible interaction between OC use and the above conditions. An important criteria for citation was publication in a high impact factor journal; furthermore to represent the wider context from which there issues derive we choose, whenever appropriate, general journal with wide readership including, but not limited to the Lancet or New England Journal of Medicine; we also choose studies published in journals of other medical disciplines instead of purely gynaecological journals to reflect the multidisciplinary impact of the combined OC pills. RESULTS: Combined OC retards bone demineralisation which could translate clinically to a reduction in postmenopausal osteoporotic fractures; it affords good menstrual cyclicity and alleviation of perimenopausal vasomotor symptoms; it offers chemoporophylaxis against epithelial ovarian cancers and endometrial cancers. There is evidence that it could be protective against colorectal cancers. The combined OC may attenuate the disease progression of rheumatoid arthritis and reduces the risk of ectopic pregnancy and pelvic inflammatory disease. In an older woman who does not smoke and is in good health, the excess risk of stroke, myocardial infarcts and venous thromboembolism is minimal, if at all, as is the risk of breast neoplasm. In women with proven human papilomavirus infection of the cervix who are using OCs, regular cervical screening is especially important. CONCLUSION: The non-contraceptive health benefits of the combined OCs justify its usage in the healthy older woman. SN - 0304-4602 UR - https://www.unboundmedicine.com/medline/citation/14626790/The_combined_oral_contraceptive_pill_in_women_over_age_forty_ L2 - https://medlineplus.gov/breastcancer.html DB - PRIME DP - Unbound Medicine ER -