Clinical complications of oral contraceptives.

Reports of complications due to estrogen-progestagen combinations are summarized. Common minor symptoms include nausea, abdominal distress, headache, depression, and weight gain. Some of these are directly due to the pill, but others are not; for instance, depression may result from pyrodoxine deficiency, but psychodynamic factors explain the problem in others. Effects on the reproductive organs include secondary amenorrhea in about 2 of every 1000 women; structural and functional changes of the ovaries, uterus, and cervix; increase in incidence of yeast vulvovaginitis; and inhibition of lactation. Most changes in laboratory values of various constituents of blood and other body fluids reflect changes in hepatic function. Thromboembolic diseases, hypertension, and hypertriglyceridemia are rare but more serious conditions for which the pill may be responsible in some cases. Contribution of the pill to carcinogenesis and fetal abnormalities has not been proven.