Thursday, December 16, 2004

Right Pill, Wrong Headline

I am seriously beginning to doubt media's incompetence when it comes to reproductive health reporting. This is a guess, but nobody can be wrong this many times. I'm going with disinterest and chasing a headline.

From an article titled Federal Agency Disputes Pill's Benefits, we find out that:

Federal officials Wednesday backed away from the findings of two major studies on birth control pills, saying the research was flawed and that a new analysis shows there is no evidence that oral contraceptives cut the risk of heart disease.

The research, presented at a medical meeting in October, created a stir because it was from the nation's largest women's health study and found that women on the pill had lower risks of heart disease and no increased risk of breast cancer. That was contrary to what many previous studies had found.

Let's go to the blog archives. What the scientist actually found and announced was (emphasis added):

The team then investigated the WHI database to examine the relationship between Oral Contraceptive (OC) use and cardiovascular health. The WHI database included some 67,000 women who used OC. They found a strong relationship between OC use and reduced risk of multiple cardiovascular disease-related outcomes, including any cardiovascular disease, hypercholesterolemia, angina, myocardial infarction, transient ischemic attack, peripheral vascular disease, and need for cardiac catheterization.


"These results are very interesting, but need further review.

And further review is exactly what is underway.

What the federal officials dispute are not the Pill's benefits, but rather the methodology of a Pill benefits study. In other words, all that can be said from the available data is that:

[The study] "could not find a relationship" between pill use and heart disease, said [Dr.] Alving.

This doesn't mean the Pill doesn't have benefits. It doesn't even mean that:

Previous studies that were more scientifically sound have found that pill-users have a small increased risk of blood clots, heart attacks and stroke....

Here's what those studies actually found:

Heart attacks

No increased risk with low-dose brands (in certain groups of women). Regardless of age, if you're a healthy nonsmoker and use a low-dose estrogen Pill brand, there's no increased risk of a heart attack.

Increased risk (in certain groups of women). If you are over 35 years old and a heavy smoker (more than 15 cigarettes/day) you have an increased risk. You should not use combination pills at all.

In addition, women in the following groups appear to have an increased risk:

-- smokers using brands containing a second-generation progestin (levonorgestrel)

-- women with high blood pressure (hypertension) and/or high cholesterol (hyperlipidemia)


No increased risk (in certain groups of women only). You don't have an increased risk if you are a healthy nonsmoker and you use a low-dose estrogen brand. However, you do have an increased risk if you use a high-dose estrogen brand (more than 50 microg).

Increased risk (in certain groups of women). If you smoke or have migraine headaches or high blood pressure, you have an increased risk, regardless of what pill brand you use.

Blood clots

All women who use the Pill have a small, but increased, risk of developing blood clots. [If you don't use the Pill your risk is extremely low, about 1:10,000; if you use the Pill your risk is still very low, at about 1-3:10,000; finally, if you're pregnant you have the highest risk, 5.7:10,000.]

The risk is highest in the first few months after you start taking the Pill; the risk increases with:

-- age

-- history of inherited blood clotting defects

-- obesity

-- smoking

-- a sedentary lifestyle

-- having delivered a baby within the past 2-3 weeks

-- prolonged bed rest (due to surgery, injury, etc.)

-- high blood pressure; diabetes

Some studies found that women using a Pill brand containing the progestin desogestrel or gestodene had an additional up to twofold increase of blood clot complications (when compared to women using a brand containing the progestin levonorgestrel). However, follow-up studies did not confirm this increased risk, and the clinical relevance of the additional increased risk findings is unclear.

Bottom line: When reading reproductive health articles, ignore the headline, and use your decoder ring to figure out what the information actually shows.


At 4:31 PM, Blogger TxHHizIf said...

You have a neat blog here. I have a site on Normal Blood Pressure that you may be interested in linking to.


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