The place of steroidal and oral contraceptives (OCs) in the broad scheme of reproductive health worldwide is evaluated. After 30 years, about 70 million couples are using steroidal contraception, out of about 380 million contracepting couples and another 380 not using family planning. The public debate about the safety of OCs is skewed by peoples; inability to appreciate concepts of relative risk, attributable risk, risk-benefit ration, and the probabilistic nature of the growth of scientific knowledge. Nevertheless, people deserve access to objective, sound information about contraceptive choices. There are several established benefits of OCs prevention of pregnancy; control of irregular menstrual bleeding; and reduction of dysmenorrhea, iron deficiency anemia, benign breast disease, pelvic inflammatory disease, functional ovarian cysts, and endometrial ovarian cancer. Several possible benefits are likely, such as less bone loss. The established risks of OCs are: rare myocardial infarction, stroke, venous thromboembolism, and liver tumor. Possible risks include breast and cervical cancer. For most of these conditions, existing evidence suggests that the trends found in studies in developed countries can be applied to developing countries. The main differences are in disorders with widely different attributable risks, such as liver tumors, which are extremely rare, but much more common in developing countries. Current overall assessments conclude that the benefits of taking OCs far outweigh the risks in developed countries and are profoundly more life-saving in developing countries, where maternal mortality and morbidity due to pregnancy are many times higher. In these areas, there are 400 million couples with no access to family planning, 140 million who conceived unwanted pregnancies in 1988, and 30-50 million who have abortions. In addition, 95

作者：E, Diczfalusy

来源：Contemporary reviews in obstetrics and gynaecology 1992 年 4卷 3期