Medical complications associated with the utilization of oral contraceptives are varied but in general stem from both known and unknown complexities associated with the ingredients that make up OCs, as all hormones are steroids and in many cases have multi-variant biochemical effects, some known and some unknown. The complexities of steroids, of which all hormones are, demonstrate the need for a great deal of further research with regards to their use. Some more common side effects of oral contraceptives, though they can vary slightly according to brand and dosage of active ingredients are:
nausea, vomiting, stomach cramps, bloating, weight change and water retention. Water retention may cause swelling of fingers or ankles. Other side effects of oral contraceptives may include nervousness, depression, dizziness, change in appetite, loss of scalp hair, rash, vaginal infections, migraine headaches, missed menstrual periods and bleeding between periods. Contact lens wearers may notice a change in vision or more discomfort in wearing their lenses. (Willis, 1985, p.28)
More dangerous side effects also occur, rarely and there is a particular warning against smoking while taking oral contraceptives as this can significantly increase the risk of serious side effects like blood clots, strokes and heart attack, and this is especially true in women who take the pill and are over 30. There is also increased risk of cervical cancer, and some other more rare cancers as well as gallbladder disease. (Klitsch, 2002, p. 176) (Lane, 2002, p. 127) (Remez, 2003, p. 150) (Mccoy & Matyas, 1996, p. 73) Side effect, both minor and serious are often noted by women as the greatest reason why they report a discontinuation of use of oral contraceptives but it should be noted that many side effects can be reduced or eliminated by changing brands or reducing therapeutic dosages to the lowest possible therapeutic level for the individual. (Willis, 1985, p. 28) Two other common but less serious side effect was shown in a recent clinical study of OCs;
More than 40% discontinued the OC within the first year, nearly 30% within the first 3 months. Discontinuation within the first three months was associated significantly with decline in sexual interest and an increase in negative mood since starting the OC, associations more marked than for any other possible side effect we measured. It is staggering how little research attention has been paid to these two effects of OCs on sexuality and mood. These results not only replicate the findings in the Scottish women in our first study, they also raise the important question of whether adverse effects on sexuality are relevant to acceptance and continuation with such methods in other cultures. (Bancroft, 1999, p. 226)
There are also other therapeutic medical uses for oral contraceptives, as doctors often prescribe them to women who have extremely painful menstrual cycles, or as the supplementation of hormones produced by the body and suppression of ovulation decreases menstrual symptoms in most women.
Aside from secondary contraceptive effects on the cervical mucus and to impede implantation, COCs primarily prevent ovulation. They therefore 'remove' the normal menstrual cycle and replace it with a cycle which is user-produced and based only on the end-organ, the endometrium. So the withdrawal bleeding has minimal medical significance, can be deliberately postponed or made infrequent as in tricycling (see below), and if it fails to occur, once pregnancy is excluded, poses 'no problem'. (Guillebaud, 2000, p. 8)
Some doctors occasionally prescribe birth control pills to treat chronic cyclical headaches. Though it is even more uncommon there are doctors who use oral contraceptives as hormone replacement therapy for women experiencing menopause, but the pharmacological components of the medications specifically used for this are very different and OCs have a greater risk to older patients, than the traditional HRT drugs.
Conclusion and Future Research on OCs and Other Forms of Contraceptives:
Controversies associated with OCs are significant and many as the most basic of human principle, the right and/or manner in which one chooses to procreate is at work in the questions associated with oral contraceptives and contraceptives in general. Is it a basic right of all individuals to control their own biological destiny through family planning? Is the most commonly asked question with regard to the medical implications as well as the social, moral and economic implications of OC use and availability, some would say yes and others would say no. Most moderates, of which there are a majority such as those who have been described here would answer that question by saying that it should be as personal a choice as the issue it wishes to control, sexuality.
Future pharmacological research and development will continue to improve upon oral contraceptives possibly further decreasing the unwanted side effects associated with the pill. Other research will include research seeking to find other routs of delivery hormonal contraceptives, a trend we can see already with patches and rings placed on the cervix. The birth control ring is placed at the base of the cervix and emits much smaller amounts of hormones as the direct delivery method blocks ovulation much faster and like the patch bypasses the digestive tract, where many medicines are rendered much less effective. Research will also likely continue to address issues surrounding the specific known side effects of oral contraceptives. It should be noted that oral contraceptives are the single most researched form of medication in the world due to the relatively young age, general overall health of women who take them and the length of time they are generally on them. Oral contraceptives for men are also a new trend in research "The more choices a couple has, the more likely they are to find one that works for them physically and psychologically,' says Scrimshaw" (Formichelli, 2001, p. 16)
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