Pills that contain the new types of progesterones may have a more neutral effect on blood lipid levels.

Liver And Gallbladder Problems

Women on the pill have a greater risk than non-users of having gallbladder disease requiring surgery. The increased risk appears within one year of use and may double after four or five years.

Although very rare, both short term and long-term use of the pill has been linked to benign and cancerous growths of the liver. The risk of liver tumours may increase in women who have been taking the pill for more than seven years. The benign liver tumours do not spread, but they may rupture and produce internal bleeding which can cause death.

The Thorny Question Of Cancer

When certain animals are given estrogen hormone for long periods of time, cancer may develop in the breast, cervix, vagina and liver. However, studies to date have not definitely confirmed that the pill causes cancer.

Since anywhere from five to 30 years can pass between exposure to an agent that causes cancer and detection of the cancer, the most accurate thing we can say at present is that it is too early to rule out a relationship between cancer and the pill.

Recently, there have been reports that women who develop breast cancer before menopause, and who had used the pill early on, especially for four years or more before their first pregnancy, have a poorer five year survival rate than women who weren't using the pill.

CERVIX: Several studies have shown that precancerous changes in the cervix are increased in women on the pill. Other studies have not confirmed this finding.

Recently, experts have speculated that there may be an interaction between the wart virus (human papillomavirus) and the birth control pill. The wart virus is a major risk factor for cervical cancer.

A 1988 update of a study that has been going on in Britain for the last 20 years links the pill with cervical cancer. The incidence of cervical cancer in women who had taken the pill for more than ten years was four times greater than for women who had not. The overall incidence of cancer of the cervix was increased in women who had used the pill.

This study has been ongoing since 1968 and does not provide information on the sexual practices of women in the study (the number of sexual partners and the frequency of sex) which are considered to be important factors in the development of cervical cancer. In addition, the women in the study were using the higher dose pill.

Nonetheless, this study is still cause for serious concern. Results from new long-term studies that are better designed may not be in for another 20 years.

Folic acid (an important co-factor needed by the enzymes that make DNA and one which is often deficient in pill users) can protect against precancerous changes in the cervix, and it is advisable for all women on the pill to take folic acid supplements, at least .8mg once a day.

Dr. Tori Hudson, Medical Director of the Portland Naturopathic Clinic in Oregon, has devised an effective herbal treatment that is applied directly to the cervix, for women with abnormal Pap smears and early cervical cancer. Some naturopaths have been trained in these techniques. Diet change and vitamin and herb supplementation are also involved in her treatment program.

Folic acid taken in dosages of five to 10mg daily can also reverse abnormal Pap smears on its own.

UTERUS AND OVARIES: Use of the pill seems to decrease a woman's risk of cancer of the womb for up to 15 years afterwards. Some studies have also shown a lowered rate of ovarian cysts and ovarian cancer in pill users. All these studies were on the high dose pill, and at this time we do not know whether the low dose pill provides the same protection.

BREAST: The jury is still out about whether the pill causes breast cancer.