Elsevier

Contraception

Volume 62, Issue 3, September 2000, Pages 113-116
Contraception

Contraception
Oral contraception and cardiovascular risk factors during adolescence

https://doi.org/10.1016/S0010-7824(00)00159-1Get rights and content

Abstract

The objective of the present study was to analyze the pattern of oral contraceptive (OC) use in teenagers and to examine the relationship between OC use and other cardiovascular risk factors. The study was conducted in 24 Belgian secondary schools. Most students (1526 adolescents aged 12–17 years) agreed to participate (participation rate: 83.6%). Smoking, physical activity habits, menarche, and OC use were assessed by a self-administered questionnaire. Total cholesterol level, blood pressure and anthropometric measurements were also measured. Fourteen per cent of mature girls (14%, n = 92) were OC users. Two-thirds of them (66.3%, n = 61) were taking OC which contained either gestodene or desogestrel. Blood pressure and BMI were similar for OC users and non-users. Total cholesterol level was significantly higher in OC users than in non-users (191 mg/dL versus 172 mg/dL). Logistic regression model confirmed the significant influence of OC use on total cholesterol level (OR = 3.08). OC users were also often smokers (39% versus 20% for non-users). In conclusion, the present study has found significant relationships between OC use and cardiovascular risk factors i.e., high total cholesterol and smoking. The first implication is a need for further research on lipoprotein profile in young OC users. Secondly, the combined use of OC and smoking in teenagers calls for preventive actions.

Introduction

Epidemiological data on oral contraceptive (OC) use during adolescence are scarce, although respectively, two studies have estimated a prevalence equal to 17 and 28% in 16-year-olds [1], [2]. However, this medication might have effects on the users’ cardiovascular risk factors. Many studies have analyzed and reviewed them in adult women [3], [4], [5], [6], [7]. In particular, the effects of third-generation pills on the risk of thromboembolism or myocardial infarction have been carefully studied [8], [9], [10], [11], [12]. Little is known on the health effects of OC use during adolescence. In particular, OC users from this age group have often a different lifestyle from the other girls. The combination between these factors and OC use might have an influence on their health. The objective of the current study was therefore to analyze the association between OC use and other cardiovascular risk factors in a population of Belgian adolescents.

Section snippets

Survey population

The present survey was carried out in the southern part of Belgium i.e., the province of Luxembourg. Eligibility criteria were age (12–17 years), Belgian nationality, and residence in the province. The participants were recruited by a multiclustered sampling technique. First, twenty-four secondary schools were randomly selected out of the 48 schools in the province. Secondly, a type of education was selected in each school. Belgian adolescents have the choice between higher learning education

Results

Six-hundred-fifty-two girls (83.7%, n = 652) had had their menarche. The median age of menarche was 12.7 years. Fourteen per cent of mature girls (14%, n = 92) were OC users and the mean duration of use was 11 months (95% CI: 1–36 months). The prevalence of OC use increased from 2 to 34% between 14 and 17 years of age (respectively, 2%, 11%, 18%, and 34% in 14, 15, 16, and 17 year olds) (Table 2). Table 3 summarizes the formulas of the OC used by the participants. Most of them used low-dose

Discussion

The first objective of the present study was to analyze the prevalence of OC use in this adolescent population. The participants represented 8% of the adolescents of the province and the participation rate was high (83.6%). A quarter (26%) of the teenagers aged 16–17 years was OC user. This proportion is similar to the proportion obtained in a sample of 16-year-old Finnish girls but lower than the prevalence recorded in a study from The Netherlands [1], [2]. The last Belgian Health Interview

Conclusion

OC use in teenagers deserves special attention given its high prevalence coupled with potential health consequences (including the associated lifestyle habits). In particular, this study has shown that the level of total cholesterol was significantly higher in OC users than in non-users. Further studies should analyze the impact on the lipoprotein profile. Moreover, OC users are frequently also smokers, despite the well-known risks of this association. All physicians should be aware of this

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