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FOR IMMEDIATE RELEASE Hopkins Report: As The Pill Turns 40, More Women Than Ever Use ItForty years after oral contraceptives were first introduced on May 9, 1960, more than 100 million women rely on them, making them the most popular contraceptive method in 78 of 150 surveyed countries, according to a new report from the Johns Hopkins School of Public Health. Outside of China and India, the pill is the most popular contraceptive method, used by some 12% of married women, according to the latest issue of Population Reports, the quarterly journal published by the Johns Hopkins Population Information Program. (In China and India family planning programs have emphasized long-term or permanent methods.) "Taken regularly, the pill prevents pregnancy almost without fail. Pill users benefit in other ways, too, such as less anemia and protection from certain cancers," according to Hopkins researchers. Iron deficiency anemia is common and often serious in developing countries. The new lower dose pills are less likely to increase the risks of certain circulatory system diseases associated with the original pill. A great many women use the pill at some point in their lives. In the United States, for example, one estimate cited in the Population Reports issue concluded that 80% of all women born since 1945 had used the pill at some time. The number of women who currently use the pill continues to grow. In China, while the percentage of married users of the oral contraceptive is low—just 3%—the number of users, at 7.6 million, is the highest in the world. There are 6.8 million married oral contraceptive users in Germany, 6.1 million in Indonesia, 6.0 million in Brazil, 5.7 million in Bangladesh, and 5.6 million in the United States. (In contrast, low-dose pills were approved for contraceptive use in Japan only in September 1999.) (Country-by-country statistics on oral contraceptive use. Full-text copy of the Population Reports issue, Oral Contraceptives—An Update.) "A method so widely used merits continuing attention from health care programs, providers, and researchers," says Hopkins researcher Richard D. Blackburn, lead author of the report. Some of the highest levels of pill use in the world are among sexually active unmarried women in developed countries. Outside Eastern Europe and Asia, an estimated 36% of sexually active unmarried women in developed countries use this method. In Europe the figure is 45% and in North America, 36%. Modern oral contraceptives (OCs) are safe for most women, and the health risks of using them are much less than the risks of pregnancy and childbearing for almost all women-particularly in countries with high maternal mortality rates, according to the report. There is some increased risk of heart attack and stroke for older OC users with hypertension or who smoke, but for those who do not smoke and who do not have high blood pressure, with today's low-dose pills risks appear to be minimal.
Emergency Contraceptive PillsOral contraceptive pills containing the progestin levonorgestrel or norgestrel with or without estrogen are increasingly used to prevent pregnancy following unprotected sex. This use of the pill was first approved in the United States in 1997. Now some pharmaceutical companies are marketing products especially for use as Emergency Contraceptive Pills (ECPs). "ECPs offer a chance to avoid pregnancy to women who did not or could not use contraception or who suspect that their regular method failed," according to Hopkins researchers. "ECPs are safe and easy to use. Virtually all women can use them, even women who have medical conditions that rule out ongoing use of OCs." The first ECP dose, totaling 0.75 mg of levonorgestrel, should be taken no later than 72 hours after intercourse. A second dose of the same amount should follow 12 hours after the first dose. Progestin-only pills are more effective as ECPs than combined pills and less often cause nausea and vomiting. If 100 women had unprotected sex during the second or third week of their cycles, 8 of them would become pregnant, according to the report. If the same 100 women used progestin-only ECPs, only 1 would become pregnant—an 88% reduction in the risk of pregnancy. Hopkins researchers make clear that "ECPs will not disrupt an established pregnancy....ECPs are not effective once the process of implantation has begun," they write. In a 4-page pull-out guide for health care providers, Population Reports lists questions and answers, steps for health care providers, instructions for use, and what women should know about ECPs. Oral Contraceptives—An Update was prepared by Richard D. Blackburn, M.S., Jacqueline A. Cunkelman, M.P.H., and Vera M. Zlidar. Population Reports is an international review journal of important issues in population, family planning, and related matters. It is published four times a year in four languages by the Population Information Program at the Johns Hopkins Center for Communication Programs for more than 170,000 family planning and other health professionals worldwide, with support from the US Agency for International Development (USAID). USAID administers the US foreign assistance program, providing economic and humanitarian assistance in more than 80 countries worldwide. For more information contact: Stephen Goldstein at Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA. Tel: 410 659-6300; Fax: 410 659-6266; e-mail PopRepts@jhuccp.org. |
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