I personally had an aunt stroke out after 20 years of birth control. No smoking, in good shape physically. Perhaps she is an anomaly, but I can’t see taking that risk for an inconvenience once a month.
Those who have genuine menstrual problems, fine. But for Suzy who thinks periods are “yukky”, this should be discouraged.
And I’ve known quite a few women who were on combination hormones from the early seventies until the big scare over PremPro. Some insisted on continuing, even after, because they couldn’t bear the withdrawal symptoms. It turns out that they were right:
“WHI Study of Younger Postmenopausal Women Links Estrogen Therapy to Less Plaque in Arteries - Experts Caution that Heart Disease Effects Remain Unclear”
http://www.nih.gov/news/pr/jun2007/nhlbi-20.htm
“Effect of Hormone Therapy on Risk of Heart Disease May Vary by Age and Years Since Menopause”
http://www.nih.gov/news/pr/apr2007/nhlbi-03.htm
The risk for strokes after 20 years on OCP’s is more closely related to the individuals’ risk of strokes at that age than to the length of time on the pills. And for those women at risk, a pregnancy would carry much more risk than the OCP’s.
The suppression of cycling has always made more sense to me because it’s better at controlling break through ovulation, which prevents the possibility of the medications acting as an abortifacient. With the combination meds, the risk of osteoporosis is decreased compared to the progesterone-only Depoprovera.