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Previous Volume 349:1443-1450 October 9, 2003 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.

A healthy, sexually active, 35-year-old woman presents for advice about the use of oral contraceptives. She does not smoke cigarettes and has no personal or family history of venous thromboembolism, myocardial infarction, or stroke. Her blood pressure is 120/80 mm Hg. Should an oral contraceptive be prescribed, and if so, how should a formulation be chosen?

The Clinical Problem

Most oral contraceptives now in widespread . . . [Full Text of this Article]

Strategies and Evidence

Benefits of Oral-Contraceptive Use

            Ovarian Cancer

            Endometrial Cancer

            Acne

            Menstrual Disorders, Loss of Blood, and Anemia

Risks Associated with Oral-Contraceptive Use

            Myocardial Infarction and Ischemic Stroke

            Venous Thromboembolism and Cerebral Venous Thrombosis

Evidence of No or Minimal Effect

Areas of Uncertainty

Particular Progestins and Vascular Disease

Screening for Thrombophilia

Hypertension and Other Cardiovascular Risk Factors

Migraine

Breast Cancer

Cervical Cancer

Other Neoplasia

Other Formulation-Specific Effects

Guidelines

Conclusions and Recommendations

Source Information

From the Research and Evaluation Department, Kaiser Permanente Southern California, Pasadena.

Address reprint requests to Dr. Petitti at Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Fl., Pasadena, CA 91188, or at diana.b.petitti@kp.org.

Related Letters:

Combined Estrogen–Progestin Oral Contraceptives
Martinelli I., Battaglioli T., Mannucci P. M., Sutherland S. E., Munarriz R. M., Goldstein I., Petitti D. B.
Extract | Full Text | PDF  
N Engl J Med 2004; 350:307-308, Jan 15, 2004. Correspondence

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