Decreased incidence of breast cancer in postmenopausal estrogen-progestogen users.

In a prospective study at Wilford Hall USAF Medical Center from 1975 to 1981, 5563 postmenopausal women were followed for a total of 37,236 patient-years of observation. During these seven years, 53 patients were found to have breast cancer, for an incidence of 142.3:100,000 women per year. The mean age (+/- SD) of the patients with cancer was 56.9 +/- 8.24 years, and the mean age of the entire patient population was 56.8 +/- 6.75 years. The expected incidence of breast cancer in this age group, according to the Third National Cancer Survey (1975), is 188.3:100,000 women, and for ages 55 to 59, according to the National Cancer Institute Surveillance, Epidemiology, and End-Result Reporting (NCI SEER) data (1980), is 229.2:100,000. The lowest incidence of breast cancer (67.3:100,000) was observed in the estrogen-progestogen users and was significantly lower than that of the untreated group (342.3:100,000), with P less than or equal to .01. The incidence of the estrogen-progestogen users was also significantly lower than that expected from the NCI SEER data, with a relative risk of 0.3 (95% confidence interval, 0.1 to 0.8). The incidence of mammary malignancy in the estrogen users (141.0:100,000) was significantly lower than in the untreated group (342.3:100,000), with P less than or equal to .01. Although the incidence in the estrogen users was not significantly lower than that expected according to the NCI SEER data (relative risk = 0.7, 0.5 to 1.1), there was a trend in that direction. These data indicate that estrogen therapy for postmenopausal women does not increase the risk of breast cancer and may afford some protection. Added progestogen to postmenopausal estrogen therapy significantly decreases the risk for this malignancy.

Changes in sexual drives of patients on oral contraceptives.

PIP: 169 married and 42 single women attending the Family Planning Clinic at Wilford Hall U.S. Air Force Medical center were surveyed over a 4-month interval to study changes in sexual drives associated with oral contraceptives (OCs). 74.4% reported they were without side effects. The menstrual flow was decreased in 62% and increased in 4%. Duration of the menstrual cycle was decreased in 57% and unchanged in 41%. 34% indicated less dysmenorrhea while taking OCs. There were some differences between married and single women when questioned about their sexual drive. 68% of the married women and 71% of the single were without change in their libido. 21% of the married women felt that their libido diminished. 22% of single women experienced increased libido. 31% of the single women had a heightened sexual response while only 17% of the married women reported this. Sexual activity increased in 40% of the single women and 16% of the married women. Libido decreased as family size increased. There were only minor differences in changes among those who use different OCs. There was a progressive decrease in libido, sexual response, and sexual activity during the first 2-3 years of medication. After 5 years, however, sexual response was progressively heightened. Fear of pregnancy was uniformly lessened with OCs in 72-75% of all patients. Individuals may have changes in their sexual drives secondary to OCs. However, as many have increased as have decreased drive.^ieng