Debate about the Combined Oral Contraceptives - Essay Example

Combined Oral Contraceptives Name: Institution: Combined Oral Contraceptives (COC) Background And Definitions Combined oral contraceptives can be defined as daily pills, which are taken by women to prevent pregnancy. They usually contain tow hormonal agents hence the reasons why they are considered combined (Edwards & Cohen, 2000). The hormones include estrogen and progestin that are produced in the body of a woman (Creinin, 2013). The hormones are in low dosage. The functionality of the pill is to ensure that the male sperms released into the vaginal tract do not fertilize released egg (Combined oral contraceptives, 2015). The effectiveness of these medications is based on several conditions. Firstly, the user should ensure that they do not miss taking the pill within a period of three days after finishing the previous one (Barth, 2010). Secondly, the user is required not to miss talking the pill for three days or more at the end of the pill pack otherwise she might get pregnant. This is also applicable to when a woman misses to take medication for more than three days in a row (Burkman & Gabbe, 2007). The use of this contraceptive must be careful prescribed for users who have medical conditions as it might have dire side effects on them. Some of these conditions include migraines with aura, heavy smokers, and cardiovascular related medical issues. It is important to consider that the use of combined oral contraceptives and the effects they have on the users (Creinin, 2013). There are positive and negative consequences that result from this usage. This paper sought to provide analytical and debatable negative results of COC hence creating a comparative evaluation of the resultant issues. Direction for Viewpoint on Combined Oral Contraceptives For over four decades, COCs have been used as a means of family planning as well as fertility regulation. Over a million women globally use this form of contraception to avoid pregnancy (Burkman & Gabbe, 2007). Due to this extensive use, there has been thorough medical research conducted on the usage of this medication. Several factors have facilitated this research including the variability of the composition of the drugs as well as the women taking them. This is because it presents a difficulty whereby the changes that occur cannot be quantified as the drugs have changed over the years (Barth, 2010). The second factor is the lack of representation of causal relationships when conducting epidemiological studies. Hence, the only valid relationship that has been developed is that which associates diseases development to use of COC (Combined oral contraceptives, 2015). According to the scientists and researchers, this relationship is somewhat biased with minimal validity. However, further studies have validated that COC use is indeed contributive to the development of particular diseases. Most of the researchers have argued pertaining to the effects of COC on its users who are mostly women. The main issues have been whether the positive benefits outweigh the negatives in terms of the wellbeing of the user (Burkman & Gabbe, 2007). Studies have indicated that the primary reason why there is continued use of these drugs is solely that they are able to empower women with controlling their fertility hence having the option of getting pregnancy and planning their families depending on their wants and needs (Creinin, 2013). There have also been other positive aspects of these drugs such as protection from ovarian and endometrial cancer. However, it is also valid to consider the negative aspects and their impact on the users’ lives in order to determine the viability of this method of contraception as being the best and least detrimental to heath (Combined oral contraceptives, 2015). This paper seeks to argue concerning these negative heath issues that arise from the use of COC. Rebuttal with Scientific Evidence Cardiovascular Risks Raised blood pressure. Disease development is one of the major risks that are associated with the use of oral contraceptives in women (Edwards & Cohen, 2000). As for combined oral contraceptives, it is observed that risks are dire due to its application of the two different hormones. Research on public health has indicated that there are several implications on the vascular systems that are associated with the use of COC (Combined oral contraceptives, 2015). This effect is considered risky, as vascular diseases are associated with heart conditions (Barth, 2010). Raised blood pressure is one of the major conditions that result from COC especially in some women who take contraceptives with lower levels of estrogen and progestogens such as gestodene and desogestrel. In instances where clinicians are diagnosing a patient for diabetes, the use of COC is likely to be the diagnosis made. The blood pressure levels are observed to rise after drug user has been on prescription for a period of six months (Burkman & Gabbe, 2007). On further usage, the blood pressure increases drastically. However, it is important to state the effect is irreversible after the discontinuation of the drugs. Myocardial infarction. According to the studies conducted, COC users face higher risks of developing myocardial infarctions unlike the other categories of patients (Creinin, 2013). It is also valid to state that there is no causal relationship between the occurrence of the condition and the duration of the usage of the contraceptives. For users that are considered smokers and hypertensive, they are at higher risk of developing myocardial infarction while using the COC (Barth, 2010). For those who have yet to report as being hypertensive are likely to develop this condition quickly. The only factor that deters the development of this condition is age of the user. It has been indicated that younger women who use COC exposed to lifestyle behaviors such as smoking are at an even higher chance of developing the condition. Hemorrhagic stroke. There is a much higher risk for COC user to suffer from Hemorrhagic stroke as compared to non-users. Studies indicate that the risk is at 2% thus having statistical siginfance (Edwards & Cohen, 2000). Studies conducted by WHO indicate that the only categories of users who are not predisposed to this condition are non-smokers, women younger than 35 years and non-hypertensive. Venous Thrombosis. Most users of COC have been diagnosed with venous thrombosis. This claim has been validated by various studies, which indicate the remarkable consistency of this causal relationship between the tow variables (Havrilesky, United States & Duke University Evidence-based Practice Center, 2013). Studies that were conducted on non-COC users validate that COC users were more vulnerable to the condition. This is because the results indicated that only less than two percent of the experimental units were susceptible to venous thrombosis. According to the studies, it was observed that the normal factors that facilitate development of the venous thrombosis do not influence its onset on COC users (Melville, 2015). Women suffering from obesity and using the contraceptives have a higher risk of developing venous thrombosis. There are users who suffer from clotting disorders such as anti-thrombin. Protein C, factor V Leiden mutation and Protein S deficiency (Melville, 2015). For such users, the highest risks will be directed towards those that are suffering from coagulation defects (Creinin, 2013). However, compared to other predisposing diseases or conditions such as obesity, the user who have clotting disorders are at a much lower risk of suffering from venous thrombosis. In considering the dosage levels, studies have indicated that users who take lower dosages of estrogen that include gestodene and desogestrel are at higher risks of developing venous thrombosis (Barth, 2010). For users who take pills with lower dosages of progestogens with the main one being levonorgestrel experience lower risks of developing the condition. Ischaemic Stroke. From the studies, ischaemic stroke poses a higher risk for users of COC. They have indicated that 3-4 fold higher risk for the users as compared to the non-users. It is important to note that the duration of use does not contribute to the level of risk the user is exposed to. As for past users of the contraceptive, it has been observed that they have a lower risk of experiencing ischaemic strokes as compared to their counterparts Cancer Risks Breast Cancer. Breast cancer has been associated with the use of combined oral contraceptives. Hence, it validates the relationship that exists from these variables. Through the analysis of data provided by Collaborative Group on Hormonal Factors, it was estimated that women who used these contraceptives from a younger age were more predisposed to developing the condition as compared to their older counter parts. This was especially more prominent in women who started using the medications below the age of 20(Creatsas, Mastorakos & Chrousos, 2000). For users that stopped using the contraceptives after a period of ten years, they faced reduced risks of developing breast cancer. In the recent day, there is an increased risk primarily based on age of the users and the type of lifestyle they practice (Speroff & Darney, 2011). Hence, it is evident that discontinued use of the COC aid in the prevention of the onset of breast caner further validating the negative side effects that are implicated with its use. Hepatocellular Carcinoma. Several studies conducted have indicated that areas with low incidence rate of hepatitis experience high risks of the COC users developing Hepatocellular carcinoma. The risk is heightened in cases whereby the user has been taking the contraceptives of more than eight years. Based on the evidence provided, Hepatocellular carcinoma is associated with long-term COC users thus validating the negative element of these drugs despite the positives presented in most literature. Summary and Major Points It is valid to state that while making the decision of using combined oral contraceptives, women should be informed on the negatives and positive effects that culminate on either a short term or long-term basis. This allows them to balance the benefits and associated risks, which is an important step in determining whether this method is suitable to them (Creatsas, Mastorakos & Chrousos, 2000). Studies that support the use of COC often mask the raised risks related with this usage despite the non-fatality aspect. The most affected population in terms of developing the aforementioned conditions are COC users especially if the contraceptives contain large dosages of estrogen (Creatsas, Mastorakos & Chrousos, 2000). It is important for there to be creation of awareness to the public on these associated risks in order to provide a platform whereby the potential COC users can make informed choices. Conclusion In the last century, the discovery of combined oral contraceptives served as a milestone in the medicine world. However, overtime there has been transformation on the formulation and its efficacy hence promoting further developments that have altered the drug (Vinogradova, Coupland & Hippisley-Cox, 2015). These modifications have been considered beneficial as well as negative with the consequences being dependent on the duration and genetic makeup of the user (Creatsas, Mastorakos & Chrousos, 2000). Some of the positive attributes of these drugs include reduction of risks of developing endometrial cancers, controlling menstrual cramps and preventing pregnancy amongst others. The negative aspects related with COC usages include increased blood pressure, breast cancer, ischemic stroke, myocardial infarction, hemorrhagic stroke, and venous thrombosis. Based on the evidence provided, it is clear that use of COC predisposes its users to various diseases and conditions, which affects their health and well-being. References Barth, V. (2010). Diagnosis of breast diseases: Integrating the findings of clinical presentation, mammography, and ultrasound. Stuttgart: Thieme. Burkman, R. T., & Gabbe, S. G. (2007). Hormonal contraception. Philadelphia, Penn: Wolter Kluwer. Combined oral contraceptives, HRT increase risk of IBD. (2015). Reactions Weekly, 1538(1), 2-2. http://dx.doi.org/10.1007/s40278-015-7306-4 Creatsas, G., Mastorakos, G., & Chrousos, G. P. (2000). The young woman at the rise of the 21st century: Gynecological and reproductive issues in health and disease. New York: New York Academy of Sciences. Creinin, M. (2013). Types of combined oral contraceptives used by US women. Contraception, 88(1), 192-193. http://dx.doi.org/10.1016/j.contraception.2012.12.015 Edwards, R. G., & Cohen, J. (2000). Reproductive choices in 2000: The relative safety of current oral contraceptives. Oxford: Oxford University Press. Havrilesky, L. J., United States., & Duke University Evidence-based Practice Center, (2013). Oral contraceptive use for the primary prevention of ovarian cancer. Melville, C. (2015). Sexual and reproductive health at a glance. Speroff, L., & Darney, P. D. (2011). A clinical guide for contraception. Vinogradova, Y., Coupland, C., & Hippisley-Cox, J. (2015). Use of combined oral contraceptives and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ, 350(may26 13), h2135-h2135. http://dx.doi.org/10.1136/bmj.h2135 Read More