As a mom of two in my early forties, birth control is something that I think about very rarely; usually only on my annual visit to the gynaecologist. After my last child, when the time came to choose birth control, I automatically discarded the pill as an option because of the stories I’d heard that it increases your chances of getting cancer.
I didn’t make my decision based on conclusive facts; it was like many of my ‘medical’ decisions – a combination of light research, conversations with other women experiencing the same thing, and a short discussion with my doctor. I remember feeling overwhelmed but pressed to make an urgent decision. In the end, the cost, convenience and side effects of the different contraceptives played a significant role in my choice too.
Now that I have had more time to think, I’ve begun to wonder if I made the right choice and whether my fears were actually unfounded, which has brought me to take a deeper look at the birth control pill. I guess what I really want to know now is, is there some truth to my worries?
What the Research Shows
In a nutshell, it seems there is a link between certain pills and certain breast cancers; but not every pill and all cancers.
American Cancer Society researchers claim that there is evidence that oral contraceptives slightly increase a woman’s risk of getting breast and cervical cancer. Similarly, a Danish study, published in 2017 by the New England Journal of Medicine, showed that contraceptives that contain hormones slightly increase the risk of breast cancer.
The reasons for why the pill would increase the risk of cancer are not completely clear. Researchers are unsure whether the risk is associated with the estrogen hormone or the progesterone hormone in the pill because some studies have indicated that a high dose of estrogen is the cause, while others have noticed a higher rate of breast cancer in women on progesterone-only birth control too. Interestingly, it seems that the longer you take birth control pills, the higher the risk. And once you stop taking the pill, the risk begins to reduce.
A US study discovered that some pills were associated with a 50% increase in the risk of breast cancer. However, according to the Daily Telegraph: “The baseline risk of women of a fertile age developing breast cancer is small, so a 50% increase in risk doesn’t amount to a “high” risk.”
What is clear is that there appears to be a stronger connection between pill usage and estrogen receptor-positive breast cancers. Known as ER+ cancers, these are cancers that are fuelled by estrogen. In other words, the risk is increased for certain types of breast cancers, and not for estrogen receptor-negative cancers. Also, it appears that high-strength pills result in a higher risk than their lower-dose counterparts. However, generally, doctors rarely/never prescribe lower-dose pills.
The Positives
On the plus side, the birth control pill has many positive aspects. It is very effective when it comes to preventing unwanted pregnancies, and it’s also beneficial when it comes to controlling PMS and acne. Low-dose pills can even result in lighter periods and less intense menstrual cramps. Researchers have also discovered that the pill may potentially lower the risk of other cancers. These include uterine, ovarian, and colorectal cancer.
David Hunter, a professor of medicine at the University of Oxford, says that the risk of breast cancer should be measured against the benefits of the pill. “Beyond the fact that they provide an effective means of contraception and may benefit women with dysmenorrhea or menorrhagia, the use of oral contraceptives is associated with substantial reductions in the risks of ovarian, endometrial, and colorectal cancer later in life,” he said.
Significantly, over time, the amount of hormones in birth control pills has been reduced. Which means there are fewer side effects today.
Who Shouldn’t Use Birth Control Pills?
What it boils down to is that the pill is safe to use if you have no major health issues. And age is not a concerning factor. The only women who shouldn’t use the pill are those who
- smoke,
- have a history of blood clots,
- had strokes or heart attacks, and
- have a history of breast cancer.
Conclusion – Each Person is Unique
My conclusion is that the pill has gained an unfair reputation and that my fears were largely unfounded. Overall, it seems that pills that contain a low dose of hormones do not increase your risk of breast cancer; however, women with a history of breast cancer or specific health conditions do need to be careful.
As with any medication, the pill has side effects as well as health benefits. The best thing to do is to weigh up the pros and cons and make your decision based on that. The fact is, like most women, I need to be on birth control. And I’m grateful that there are options available that have relatively little impact on my daily life.
Ultimately, each person is unique and a decision about birth control should be made based on your personal health history, what you can afford and access, and your personal preference and tolerance when it comes to side effects.
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About the author: Julia Riccardi is a freelance writer and editor based in Johannesburg, South Africa. She has a BA in English and Comparative Religion and a passion for words, people, and holistic health.