Possible hazards of oral contraceptive use.

Implications of serum lipid aberrations which accompany the use of oral contraceptives are considered. Oral contraceptives have been reported to affect all serum lipids but their effect on the triglycerides and VLDL is most consistent and striking. Oral contraceptive-induced hypertriglyceridemia appears to result from enhanced VLDL production stimulated by estrogen. Estrogen-containing oral contraceptives may secondarily raise the serum total cholesterol by elevating the VLDL and the HDL cholesterol containing lipoprotein fractions. Type 5 hyperlipoproteinemia may be induced by oral contraceptive use in women with type 4 abnormality which may also occur with ethanol intake in oral contraceptive users. These effects must be put into perspective since no contraceptives in use have an associated death rate as high as that for pregnancy or abortion. However oral contraceptives worsen the major atherogenic cardiovascular risk factors to some degree in all women. However the full impact of oral contraceptives on these risk factors may not be fully realized from the short duration studies done so far. It is recommended that more specific guidelines are needed for monitoring women on oral contraceptives for worsening of their atherogenic traits and changes in blood coagulation. Indications and contraindications for oral contraceptive use must be better defined in relation to their thromboembolic hazards.