LAUSR

Key Points Question What are the quality and certainty of evidence for an association between hormonal contraceptive use and the risk of adverse health outcomes in meta-analyses of randomized clinical trials and cohort studies? Findings In this umbrella review of 58 meta-analyses of randomized clinical trials and cohort studies describing 156 associations between hormonal contraceptive use and adverse health outcomes among women, no associations with adverse outcomes, including cardiovascular and cancer risk, were supported by high-quality evidence. However, the association between the use of a levonorgestrel-releasing intrauterine system and reductions in endometrial polyps associated with tamoxifen use was graded as having high-quality evidence. Meaning The results of this umbrella review supported preexisting understandings of the risks and benefits associated with hormonal contraceptive use, suggesting that the associations between hormonal contraceptive use and adverse health outcomes are not supported by high-quality evidence.