Midlife Women May Be Missing Out on Pill's Benefits

From the WebMD Archives

Aug. 30, 2000 -- Women often take oral contraceptives in their youth to prevent pregnancy or to regulate their periods, but many of the more than 20 million U.S. women aged 35 to 44 are unaware that they can still get important health benefits from taking low-dose birth control pills, according to a recent poll.

Misperceptions about oral contraceptives among women in this age group abound. And because of that, women may be missing an opportunity to add quality years to their lives by taking birth control pills during the 'transitional' years in which they are moving toward menopause.

During the time preceding menopause (called premenopause), the ovaries function less consistently, and women experience changes in their reproductive systems that can lead to heavier menstrual periods, night sweats, hot flashes, and changes in their skin. But taking birth control pills may make this transition easier while delaying or preventing the development of certain health problems, including osteoporosis and some types of cancer.

"Low-dose pills are specifically designed for women older than 35, and they can take them until menopause to ease transition into menopause," says Donnica L. Moore, MD, president of the Sapphire Women's Health Group in Neshanic Station, N.J.

But the national poll of 3,200 midlife women found that the majority have not discussed their reproductive health concerns with their doctors and that many have been misinformed about the benefits and risks of taking oral contraceptives, says Moore, who discussed the results at a press conference in New York. The survey was conducted by Harris Interactive Inc., by phone and online.

For example, more than half of all pregnancies in the transitional age group are unintended, and 79% of the women ages 35 to 44 who were polled said they were not concerned about unplanned pregnancy. Only 30% of women in this age group use contraception, the survey found.

Yet "the issue of unintended and unwanted pregnancy in transitional women is nearly as high as it is among teenagers," Moore says.

Most women in this age group are concerned with developing life-threatening diseases, including breast cancer, heart disease, the brittle-bone disease osteoporosis, and ovarian or uterine cancer, the survey showed.

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Still, eight in 10 women don't know that the pill can help prevent ovarian and uterine cancer. One study, the Cancer and Steroid Hormone study, found a decreased risk for ovarian cancer in women who had taken birth control pills for as little as three to six months. In addition, oral contraceptives have been found to lower the risk of colon cancer and reduce a woman's risk of developing osteoporosis by strengthening bones. The data on how they may affect a woman's risk of breast cancer are inconclusive.

Although more than 60% of the women polled said that they thought women needed to take breaks from the pill to give their bodies a rest, the truth is that extended use of low-dose pills is associated with even more preventive health benefits.

That's why 52-year-old Penelope M. Bosarge, RN, plans to stay on the pill until she reaches menopause. When her periods became much heavier at age 35, Bosarge went on low-dose oral contraceptives. After a brief time off of the pills, she decided to go back on them.

"The exciting part is that not only can I manage my bleeding, but I am getting noncontraceptive benefits as well," says Bosarge, who is concerned about developing osteoporosis because her mother has the disease.

Suzanne Trupin, MD, a veteran gynecologist, says she offers oral contraceptives to anyone who is a candidate for them and who needs contraceptive protection, relief from symptoms such as hot flashes, or relief from PMS. 'The pill' is also an option to help women with such conditions as fibroids, endometriosis, and adenomyosis.

Women with a history of ovarian cysts or with polycystic ovary syndrome or similar conditions can also benefit from the pill, Trupin tells WebMD. And women who have risk factors for cardiovascular disease may benefit from low-dose oral contraceptives because of the effects on blood-fat levels.

Trupin says that women with a family history of cancer of the uterus, ovary, and colon might lower their risks by taking oral contraceptives over an extended period. Trupin, who was not involved in the poll, is head of the Women's Health Practice in Champaign, Ill.

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Women who should not take birth control pills include those with conditions such as undiagnosed genital bleeding, certain types of tumors, liver disease, or active blood clots, or those who are pregnant.

But for those women who are candidates for oral contraceptives, selecting a particular pill is an individual process. The lowest-dose birth control pill contains 20 micrograms of the hormone estrogen. This pill is 99% effective at preventing pregnancy, and reduces the risk of most common pill side effects such as weight gain, nausea, and breast tenderness.

"Ask your doctor which pill formulation is right for you," Moore says.

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