Risks Oral contraceptives have a confirmed cardiovascular risk. The estrogenic component would be responsible for the production of venous thrombosis, leading to an increase of fibrinogen and factors II – VII – IX – X, protein C and S and antithrombin III. Estrogens have atherogenic effect by increasing LDL-c and decreased HDL-c, and increased insulin resistance. In smokers cardiovascular complications are more apparent. The current preparations with lower doses have minimized the danger, and although the thrombotic risk increases with age, remains low compared for example with the pregnancy. Preparations with 30 mg of estrogen do not affect coagulation parameters, but it is accepted that smokers over age 35 should not take oral contraceptives. The new progestins with less androgenic activity may have a favorable action on lipids and may even protect the cardiovascular risk.The use of oral estrogen (birth control) suffer from the disease Liednen heterozygous factor V multiplied by 35 the likelihood of thromboembolic processes (the probability of suffering such complications without the use of estrogen is multiplied by 7 in such patients, if the mutation is homozygous this probability is multiplied by 80) Another problem with oral contraceptives is the occurrence of hypertension, reversible on stopping treatment. Owing to the increase of plasma angiotensinogen. The current preparations with fewer doses would have a minimal effect but should be monitored periodically. Hypertension influence the risk of myocardial infarction (AMI), and in patients with marginal cardiac reserve should not be used this method because accidents can be precipitated by fluid retention. Estrogens decrease glucose tolerance, increasing insulin levels and glucose by increasing peripheral resistance to insulin action.With current preparations these changes are minimal and even in patients at risk, not cause an increase in diabetes mellitus. In diabetic patients must take into account the risk of thrombosis, although up to 35 years the risk is minimal and can use these formulas with low doses. Estrogens increase HDL-C and LDL-c progestogens, therefore the effects depend on the dose used. Currently as low doses are used, the changes have little clinical significance. Much of the side effects of oral contraceptives have to do with a change in the levels of liver enzymes. Estrogens cause an increase in protein synthesis. Cholestatic jaundice and itching are occasional complications when used at high doses. The only absolute contraindication to liver would cause acute or chronic cholestasis and a severe shortage. After a hepatitis recovered from the acute phase, can be used contraceptives.Have referred gallstones increase the first year in susceptible women. The mechanism appears to result from alterations in the composition of bile by the rise in cholesterol saturation due to estrogenic effect. It has a protective effect against endometrial cancer risk by reducing by 50 and its effect persisted for 15 years or after treatment. Also against ovarian cancer, assuming a 40 reduction in the incidence and maintaining its effect at least 10 to 15 years after treatment. Increased risk of dysplasia and carcinoma in situ of the cervix but has not been entirely confirmed, but is recommended cervical-vaginal smears in all contraceptive users. Hepatocellular adenomas may arise caused by the steroids, are not malignant, but are related to the risk of bleeding. They relate to the duration of treatment, and return to suspended. With regard to breast cancer, their relationship has not been clarified.It confirms its protective influence on benign breast disease. Its role in breast cancer could be confined to accelerate growth or to facilitate early diagnosis by the increased vigilance to which are always subject women taking contraceptives. Today we can say that contraceptive use during reproductive age is not associated with a significantly increased risk of breast cancer over 45 years, although there may be a group of youngsters that if they started treatment early and have kept more than 4 years, will have a slightly increased risk of breast cancer before age 45. Of the other cancers, melanoma has shown some epidemiological link to contraception, but their biggest risk factor remains the sun.

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