Improving QOL through contraception health benefits

Elof Johansson

Population Council, New York, NY USA

The world in 2006 has 1,773 millions of young people age 10-24 years. This number of young people is 27% of world's population and the largest number of young people the world has ever seen.

This youth cohort needs effective and safe contraceptives in order to get education and a place in society. Unwanted pregnancies is a very severe health problem and thus the pregnancy preventative effect is the most important health effect of any contraceptive. The current estimate is that some 600,000 women die every year due to pregnancy related causes, including deaths due to unsafe abortions. The ability to avoid unwanted pregnancies is very important for the quality of life for all women. For women in developing countries it can also be a life and death issue.

Young women also have special needs. They suffer more than older women from painful periods. They struggle to adjust to the inconveniences of the menstrual periods with soiled underwear and bed linens as a result. Oral contraceptive use significantly reduces the use of painkillers, soiled underwear and bed linen. The end effect is increased school attendance.

Reduction of menstrual blood loss comes up at the most important health benefits of oral contraceptives and Mirena. Mirena, in particular, with its scant or no bleed is popular with somewhat older women, who can compare with other methods and also as years go by get fed up of the monthly bleeding days. Both in developed and developing countries, menstrual blood loss reduction improves quality of life and is an important health benefit. In some developing countries up to 50% of women with menstruations suffer from anemia.

The long-term preventative effect on the development of endometrial and ovarian cancer shown for oral contraceptives will with the aging of the world population be more and more important, but it still is secondary to the health effect of avoiding unwanted pregnancies.

More studies are still needed to evaluate the effect on vaginal and pelvic infections in women with different contraceptives and in different cultural settings. However, the evidence is strong on the safety of available contraceptives including Copper IUDs. The issue is how much hormonal contraceptives will protect against pelvic infections.