Oral contraceptives: the risks in perspective.

In 1968 three large prospective cohort studies were begun for the purpose of studying the long-term effects of oral contraceptive use. In all three studies, the major serious side effect of oral contraceptive use was an increased risk of circulatory mortality; this risk, however, was concentrated in older women who smoked and all women over the age of 45. The concept of risk is poorly understood by many consumers and providers of health care. This article explains the concept of risk and how it is determined, and reviews the most recent findings of the cohort studies relative to pill-related mortality. Comprehension of the concept of risk relative to pill-related mortality and its implications for nursing practice will assist nurses in providing their clients with the knowledge base necessary for an informed choice regarding contraceptive method.