In Great Britain over 3 million women are now using oral contraceptives, i.e. one in three women of child-bearing age. ‘The pill’ has major advantages in addition to its reliability. It has helped many heavily populated countries to achieve lowest-ever birth rates. Fewer and fewer abortions are being performed. Periods are less often painful. On the other hand women on the pill have a somewhat increased chance of migraine, depression and weight gain. And there is now rather clear evidence from the work of Drs Vessey, Mann, Oliver and Shapiro of an increased risk of diseases of the heart and circulation. Deep vein thrombosis (formation of clots in the veins of the legs) was the first to be recognized. It may lead to swelling of the leg and foot, with or without pain. If the clot is carried away in the blood stream it lodges in a lung artery; this is known as pulmonary embolism. A large clot can obstruct the circulation and may need medical treatment or an operation. Smaller clots produce symptoms like pleurisy, with sharp pain in the chest on breathing; the patient usually coughs up bloodstained phlegm.*1/202/5*
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