Talk:Combined oral contraceptive pill

100 million?

Not sure where the 100 million came from. The first ref [1] deals only with the US and has no mention of 100 million or world figures. The second ref [2] also has no reference to world figures it is to do with US only. The 3rd ref is a UN wall chart [3] . As it is a wall chart it is a little hard to read on screen (increase resolution and you can't see all the figures on the screen ...). However as I read the figures, on the top left hand side they sate that in 2005 there were 1,097,427,000 women in the world aged between 15-49 who were married or in union. Of these 7.5% used the pill. 7.5% of the number of women given is 82,307,025 - this is not more than 100 million. There is no mention of 100 million using the pill in that ref. This 3rd ref also does not support that fact.--Matilda (talk) 20:23, 13 November 2008 (UTC)

To me it looks like some poeople outside a stable relationship (-> marriage) will also use the pill. However, we could change that to say "over 80 million" and then use the UN wall-chart ref to support that.--Eptalon (talk) 21:30, 16 November 2008 (UTC)

I think that people outside a relationship are very likely to use the pill but as to how many we don't know and we should stick to only those facts we can verify. Over 80 million is fine and the footnote can explain the calculation - I will expand the footnote just a little bit.--Matilda (talk) 21:49, 16 November 2008 (UTC)

By way of comparison, the chart gives 37,550,000 women in marriage or union in the United States. Of these 15.6% use the pill which = 5,857,800. We cannot infer that there are 160 million women using the pill worldwide - ie double the number because the US number from other sources is double. Other cultures may have much more significant taboos on prescriptions of the pill to women who are not married or in consensual unions. I don't know! What surprises me actually is how low the percentage in the US is for arelatively cheap, safe and easy form of contraception. In Australia 24% of married women (or those in equivalent union) take the pill, in western Europe 47% of such women take the pill with Germany's population at 58.6%. The differences are fascinating for countries of roughly equivalent socio-economic status. --Matilda (talk) 22:05, 16 November 2008 (UTC)

(unindenting) You can only cite the figures you get, but given that 82 million in a stable union (marriage or equivalent) used the pill, I think than saying that 18 million outside such a relationship do is not that big a step; might also want to talk about pill vs. other methods of contraception available for women; also might want to mention that this is a means of contraception, ie. it does not protect against sexually transmitted diseases (unlike for example the condom, which can also do that). Another idea: Most "emergency contraception" is also hormonal, and could also be mentioned. But I am neither woman, nor doctor, nor pharmacist, so probably not the best person to extend the article.--Eptalon (talk) 22:14, 16 November 2008 (UTC)

Extending the article

As already stated, I think it may be good if the article could be extended (and the following sections be "ported" from EnWP)

• Drug interactions (some drugs to treat epilepsy, certain drugs to treat sleeping problems)
• Hormonal pill contain hormones; people that have problems witrh their homones may take them against these problems, rather than as a contraceptive.
• Social and cultural impact

To a lesser extent: mention that like any drug, the pill can have side-effects/unwanted effects

• Link to emergency contraception (which is also hormonal)

These are of course just my thoughts/suggestions --Eptalon (talk) 17:23, 17 November 2008 (UTC)

If the article was about "the pill" = hormonal contraception or oral contraceptive, then I think it could include the minipill and emergency contraception - if not then the links should just be wikilinks where relevant and see also. My preferred article title is oral contraception. I certainly think the minipill (progesterone only) could usefully be included as a subhead to explain why it is different and why it was developed and when it is used - eg when breastfeeding. All these things help one to better understand when the combined pill is better and when not.

note there was significant scare relating to thrombosis and use of the pill declined in the UK at least in 1995 - see

• Venous thromboembolism rates have not fallen since "pill scare" BMJ 2000 321: 0 from abstract:

  Setting: United Kingdom, January 1993 to December 1998.
  Subjects: Women aged 15-49 taking combined oral contraceptives.
  Main outcome measures: Incidence of venous thromboembolism.
  Results: Use of so called "third generation" combined oral contraceptives fell from 53% during January 1993 to October 1995 to 14% during November 1995 to December 1998. There was no significant change in the incidence of venous thromboembolism between the two periods after age was adjusted for (incidence ratio 1.04, 95% confidence interval 0.78 to 1.39).
  Conclusions: The findings are not compatible with the assertion that third generation oral contraceptives are associated with a twofold increase in risk of venous thromboembolism compared with older progestogens.

• The 1995 pill scare revisited: anatomy of a non-epidemic in Human Reproduction, Vol 12, 2347-2357, Copyright © 1997 by Oxford University Press from abstract:

  Two years after the October 1995 pill scare that received worldwide attention, this synthesis of evidence goes back to the earliest research on risks of first generation oral contraceptives (OCs). It also covers epidemiological data published since, emphasising the 1995- 1996 findings. Late breaking data are also examined. The key issue: are there differences in the risk profiles of second and third generation OCs. The ultimate question is: did any epidemics of venous thromboembolism (VTE) occur? This synthesis of evidence leads to the following conclusions and observations: (i) all OCs on the market are becoming progressively safer; (ii) relative risks of about 2 for VTE, even if real, are clinically unimportant and of no public health significance; (iii) the weak odds ratios contrasting third and second generation OCs, ranging from 1.5 to 2.3 in the 1995-1996 studies are more likely explained by bias than by a causal relationship; (iv) incidences of VTE among users of any OC have been declining over the past three decades; (v) absolute rates of VTE for third generation OC users reported in 1995-1996 are lower than those for users of second generation OCs in 1988 and 1991; (vi) there is no difference in risk of VTE between first starters on second generation OCs versus first starters on third generation OCs; (vii) users of third generation OCs are at much lower risk of acute myocardial infarction than users of second generation OCs; (viii) among users of any OC, the occurrence rates of stroke are low, they are declining, and no differences between second and third generation OCs are apparent; (ix) 2 years after the pill scare there are no epidemics of VTE; (x) there have been excessive rates of therapeutic abortions in some countries; and (xi) the benefit- risk ratio is favourable for users of any OC.

--Matilda (talk) 00:12, 18 November 2008 (UTC)

Added some (freely available) articles, as refs; We can extend the article no matter what to explain that there different pills use different combinations of hormones; once the minipill section is big enough, make an article, and link...--Eptalon (talk) 11:38, 18 November 2008 (UTC)

Section added, needs proofreading, sourcing and extending--Eptalon (talk) 17:00, 18 November 2008 (UTC)

Minipill is not a COCP

Progesterone only is not a combined pill. If we write about that pill better to rename the article. As above I think it is better to have one article on hormonal contraception than 3 but it does require a rename and then redirects. --Matilda (talk) 21:28, 18 November 2008 (UTC)

When changing, the following should be kept in mind:

• Drug interactions/side-effects/Cancer protection are different
• Is there a way to keep the "non-contraceptive uses" section?

We might end up with one article, plus one article for each of the pills --Eptalon (talk) 09:16, 19 November 2008 (UTC)