It seemed like something of a miracle pill.

Not only would Yaz prevent pregnancy, it would treat symptoms of premenstrual dysphoric disorder - a dramatic form of premenstrual syndrome - according to its commercials. The oral contraceptive manufactured by Bayer quickly became popular.

Then, last October, came a citation from the U.S. Food and Drug Administration that Bayer had been deceptive in its advertising, overstating the benefits of Yaz while distracting viewers from its risks - including a risk of blood clots, which Yaz is 6.3 times more likely to cause than other birth-control pills, according to an article posted last month on InjuryBoard.com that also mentions lawsuits that have been brought against Bayer on behalf of women who suffered heart attacks, strokes, deep vein thrombosis, pulmonary embolism, gallbladder disease or sudden death while on Yaz.

This isn't to say hormonal contraceptives commonly cause such serious side effects. But the FDA's citation of Yaz commercials has caused concern for some women, says Dr. Lisa Brennaman, an obstetrician/gynecologist with Heartland Women's Health.

"Unfortunately, many young women are in need of contraception, and none are completely without risks," she adds, also noting that when faced with the dilemma of taking these risks or risking an unwanted pregnancy, women often opt for the former. "It really comes down to choosing contraception with the fewest possible side effects."

But how should women go about this, and how concerned should they be, really, about risks posed by hormonal contraceptives?

Dr. Brennaman says she helps women choose a method of birth control by asking questions such as how important it is to them to prevent pregnancy, whether they're married and/or monogamous, what their expectations are of their future fertility and whether they have any habits or conditions that could increase their chances of being adversely affected by a birth-control pill. One such habit is smoking, she says, which increases a woman's chance of suffering deep vein thrombosis, heart attack or stroke while on contraception.

But for healthy women, she adds, "I don't think contraception is something they should feel afraid of. Birth-control pills have gotten safer over time."

Something that's made them safer is the fact that today's pills contain low doses of estrogen and progestin compared to the first generation of birth-control pills, created in the 1960s, which studies have linked to an increased risk of breast cancer.

But despite being safer today, estrogen-progestin contraceptives still are classified by the International Agency for Research on Cancer, part of the World Health Organization, as carcinogens. According to the National Cancer Institute, they can increase a woman's risk of developing breast or cervical cancer, even as they decrease her risk of developing endometrial or ovarian cancer. And if a young woman is diagnosed with breast cancer, she's advised to stop taking birth-control pills, because some tumors grow when exposed to estrogen and progestin, says Kristen Thatcher, a registered nurse with Heartland's breast center.

Still, many researchers and doctors don't consider the possibility of a link between birth control and cancer to be significant in comparison to the benefits birth control provides - and many women don't think about the risk at all, simply because those young enough to need contraception aren't old enough to be in the age group most affected by cancer, Dr. Brennaman says.

But some women are concerned about the risks and are seeking alternatives to hormonal contraceptives. Marla Daugherty of St. Joseph, who works as a practitioner with FertilityCare Center of Kansas City and teaches women to chart their cycles as a means to naturally avoid or achieve pregnancy, says she's had a few women in her classes who chose this form of birth control because they're "more health-conscious, more into green, natural approaches." "Plus, those health risks listed in commercials - strokes, heart attacks, certain cancers - those are not small risks," she adds. "Even though they don't affect 100 percent of women, for those women who are affected, they're 100 percent affected."

Lifestyles reporter Erin Wisdom can be reached at ewisdom@npgco.com.