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.