Trends in the content and use of oral contraceptives in the United States, 1964-88.

Abstract

Drug marketing and physician survey data were used to examine trends in the use and hormonal content of oral contraceptives in the United States between 1964 and 1988. Retail prescriptions for oral contraceptives peaked at approximately 68 million in 1973 and have remained between 50 million and 60 million since 1981. Despite this relative consistency in the number of prescriptions, physician "mentions" of oral contraceptives have increased by approximately 75 percent. This increase may reflect closer monitoring of women on oral contraceptives. Use of multiphasic formulations has steadily risen, accounting for 37 percent of the oral contraceptive prescriptions in 1988. Mean estrogen and progestin doses in all types of formulations have steadily declined. A change in the type of estrogen and progestin used in preparations has coincided with this decline in dose. The association between age and use of high-dose formulations seen in the past was no longer evident in 1988. The data demonstrate that oral contraceptive formulations in wide use today differ in hormone content from those of the past, when most of the major studies addressing the risks associated with oral contraceptive use were completed. There is therefore a need to determine the risks and long-term effects associated with these newer formulations.

Hyperostosis frontalis interna: What does it tell us about our health?

“…Thus, today's females have approximately triple the amount of cycles during their reproductive years (Strassmann, 1999) than females living 100 years ago. Another source of hormonal alteration was the introduction, since the mid 20th century, of hormonal manipulation (i.e., contraceptives, hormonal replacement therapy) into the female population of the Western World (Gerstman et al, 1991;Jones, 1999;Stefanick, 2005). In this respect, it is possible that the common use of contraceptives among teenage girls may explain the earlier onset of HFI in the present day population.…”

Oral, injected and implanted contraceptives and breast cancer risk among U.S. Hispanic and non‐Hispanic white women

“…Typical OC formulations prescribed in the U.S. in the 1960's contained 1, 2 or 10 mg of progestin and 50-100 lg of estrogen, 24 and thus women reporting use during this time period would have been exposed to what are now considered high doses. OC use during the 1970's represents a mixed set of exposures, as products containing 0.5 mg of progestin and <50 lg of estrogen became available, but a large proportion of prescriptions continued to be for the higher dose formulations.…”

“…OC use during the 1970's represents a mixed set of exposures, as products containing 0.5 mg of progestin and <50 lg of estrogen became available, but a large proportion of prescriptions continued to be for the higher dose formulations. 24 During the 1980's, most prescriptions contained 1 mg of progestin and 50 lg of estrogen. 24 Since that time, OC containing 0.15-1 mg of progestin and 35 or 30 lg of estrogen have remained prevalent; compounds containing 20 lg of estrogen or less were introduced but represented only 8% of prescriptions in 1998.…”

“…24 During the 1980's, most prescriptions contained 1 mg of progestin and 50 lg of estrogen. 24 Since that time, OC containing 0.15-1 mg of progestin and 35 or 30 lg of estrogen have remained prevalent; compounds containing 20 lg of estrogen or less were introduced but represented only 8% of prescriptions in 1998. 25 It has been suggested that increased breast cancer risk may have been associated with exposures to older, high-dose formulations of OC, but that modern, low-dose OC will not be associated with breast cancer.…”

A cluster of inflammatory breast cancer (IBC) in an office setting: Additional evidence of the importance of environmental factors in IBC etiology

“…A number of studies showed no association with OC use on prognosis (27-31), a number found that OC users had smaller tumors and were less advanced clinically (32,33), and a number found that OC users had a worse prognosis (9,(34)(35)(36)(37). It is difficult to compare the studies because many of the studies have not investigated dose and composition and these have changed over time (38).…”