The Current Status of Oral Contraceptives: Progress and Recent Innovations

Abstract

Millions of women in the United States and abroad use oral contraceptive pills. These popular contraceptives are the most common reversible birth control method in the United States, and a wide variety of pills are available for prescription. Oral contraceptives provide safe and effective protection against pregnancy and offer several noncontraceptive benefits. Over the years, advances in the laboratory and knowledge gained through epidemiologic data promoted the development of new contraceptive preparations. Generations of oral contraceptives emerged over time, containing lower doses of estrogens and new and novel progestins. The current review discusses the clinical characteristics of oral contraceptives, with emphasis on basic pharmacology and the evolution of various contraceptive formulations and regimens.

Modification of the Associations Between Duration of Oral Contraceptive Use and Ovarian, Endometrial, Breast, and Colorectal Cancers

“…We did not have information on recency of OC use or OC formulation, but our participants were likely using first-and second-generation drugs (marketed before 1989); these drugs contained higher doses of estradiol and progestins with more androgenic activity compared with newer OCs. 2,30 If the primary mechanism of these medications is altering hormone metabolism, the associations between newer medications and cancer risk may differ for future cohorts. Therefore, continued study of OC use as primary prevention for cancer is warranted.…”

Oral Contraceptive Use and Risks of Cancer in the NIH-AARP Diet and Health Study

“…Our participants were likely using firstand second-generation OCs, which were marketed before 1989 (2, 7). Relative to firstand second-generation OCs, third-generation (1990-2000) and fourthgeneration (after 2000) drugs tend to contain lower doses of estradiol and progestins with less androgenic activity (2,7). As such, we might expect that cancer associations with firstand secondgeneration drugs are the strongest.…”

“…There is increasing evidence that suggests a hormonal etiology for many cancers in women, yet much remains to be learned about the influence of exogenous hormones. Furthermore, the formulation of OCs has changed considerably since their debut, which may mean that associations between OC use and cancer development will change over time (2,7). As such, it behooves us to continue investigating OC use and cancer.…”

Use of oral contraceptives for management of acne vulgaris and hirsutism in women of reproductive and late reproductive age

“…Among 17-OH progesterone derivates nomegestrol, medroxyprogesterone acetate, cyproterone acetate, and chlormadinone acetate are used. Among 19-nortesterone derivates there are three generations that differ in relation to antigonadotropic, progesteronic, and androgenic properties [ 12 ]. First-generation progestins have both progesterone and androgen receptor affinity, while second-generation progestins are more progestagenic and less androgenic.…”