Age, metabolism and oral contraception.

PIP: Because of the elevated risk of pathological problems for women over 35, the recommendation for an oral contraceptive (OC) must be carefully considered after the physician has studied the individual's health history and assessed the risks. The physician is responsible for understanding specific needs of each patient as well as understanding risks inherent with the aging process of the female population such as an increased risk of diabetes, a rise in weight and blood pressure, and an increased risk of heart disease. The administration of exogenous hormones and the affect of these hormones pertaining to each of the risk areas is studied. Studies concluding that estrogen deficiency is related to hypertension risk seem to support the assumption that estrogens counteract the development of hypertension. However, other studies have shown an increase in the incidence of hypertension following OC intake. Exogenous hormones have not been linked to an increase in the volume of fat cells. Oral contraceptives do not increase the risk of diabetes if there is no genetic disposition to the disease; patients who do show evidence of the existing disease should be carefully monitored. A further conclusion is that oral contraceptives have a minimal affect on blood clotting. The most effective way to limit health hazards is by limiting the dosage and the frequency of hormonal contraceptives. With careful medical supervision, older women can be open to alternative methods of contraception including oral contraceptives with a minimal level of use.^ieng