Peptic ulceration and the use of oral contraceptives. A negative correlation attributable to the disease?

The development of active peptic ulceration during pregnancy is widely regarded as uncommon, and, in the case reports that have been published, ulcer activity occurred close to the time of delivery (Sandweiss, Saltzstein, and Farbman, 1939; Jones, 1947; Rider, Kirsner, and Palmer, 1953). Furthermore, pregnancy is believed to have a beneficial influence on the course of pre-existing acute peptic ulceration (Clark, 1953). These observations have prompted therapeutic trials using synthetic analogues of the hormones that are normally elevated during pregnancy, some of which appear to have shown that oestrogens may have a favourable effect on the healing of both gastric and duodenal ulcers (Truelove, 1960; Doll, Hill, and Hutton, 1965; Parbhoo and Johnston, 1966). It occurred to us that the use of oral contraceptives containing oestrogen might reduce the risk of peptic ulceration, and a pilot study was undertaken to examine this hypothesis.