Excess mortality and the pill. (Editorial)

2 recent publications indicate that the excess mortality in women who are taking or who have taken oral contraceptives is much higher than previously believed with causes due to a cluster of cardiovascular complications. Reported data indicate that the death rate from diseases of the circulatory system in women who had ever used oral contraceptives was 5 times that of women who had never used them. Recommendations from the Presidents of 2 Royal Colleges are helpful guidelines in translating this data into comprehensible terms: Women under 30 should not need to discontinue oral contraceptive use but should stop smoking; some women over 30 ought to reconsider their use of oral contraceptives and should also stop smoking; women over 35 should consider another method of contraception; and those women who smoke and/or have used oral contraceptives continuously for 5 years or more may incur extra risks. It is concluded that the young nonsmoking woman who uses the pill to space children seems to have no reason to be alarmed while for women over 30 particularly smokers a change of method should be seriously considered.