As misinformation about women’s health spreads faster than ever, doctors say new research on the risks of hormonal contraceptives highlights how difficult it is to communicate nuancedly in the age of social media.
This extensive study, conducted in Sweden, followed more than 2 million teenagers and women under 50 for more than 10 years. Results show that hormonal contraceptives are generally safe. However, small differences in breast cancer risk were confirmed depending on the type of hormone used in the composition. Additionally, a small short-term increase in breast cancer diagnoses was seen among people who were already using birth control pills or had been using them for a short period of time.
These results are consistent with previous studies: Danish analysis published in 2017 and 2023 meta-analysis (Meta-analysis in medicine is a statistical technique that combines the results of multiple independent studies to reach more accurate and definitive conclusions about a specific topic.)
This study was published online on October 30th. JAMA Oncology.
Doctors said the results would not change current recommendations and that women should not stop using birth control pills.
Nonetheless, factual warnings circulating on TikTok incorrectly claim that birth control causes cancer and is as dangerous as smoking. Reproductive health advocates are alarmed by studies like this one. easy to do taken out of context at social network It boils down to astonishing numbers.
yes: research Women who used hormonal contraceptives reported an approximately 24% higher risk of breast cancer compared to women who never used them. However, because breast cancer is still rare in young women, this rate has increased from about 54 to 67 cases per 100,000 women per year. That’s about 13 additional cases per 100,000 women, or 1 additional case per 7,800 hormonal contraceptive users per year.
Study authors Åsa Johansson and Fatemeh Hadizadeh, epidemiologists Uppsala UniversityThey stated that the increase is mild and temporary and that the risk is higher during use and decreases 5 to 10 years after discontinuation of use.
Rachel Fey, interim co-CEO of Power to Decide (an organization whose mission is to provide accurate information about sexual health and birth control methods) said these types of nuances are often lost on social networks.
“This makes me very angry because it’s designed to scare people like me away from birth control. This has improved my life in so many ways,” she said. “It’s very frustrating… especially when it’s presented without context. And in this age of social media, that content can go viral without anyone in the know putting it into perspective.”
The study also found a slightly higher risk for certain progestins, such as desogestrel, found in combined oral contraceptives such as Cyred EQ, Reclipsen, Azureette and Pimtrea, but no increased risk for other products, such as medroxyprogesterone acetate injection sold under the brand name Depo Provera.
How to interpret your results
Some experts caution that the results should be analyzed with caution because the study counted both cases of invasive breast cancer and early-stage non-invasive lesions known as tumors that may not be life-threatening. Including these precancerous cases may make the overall risk of clinically significant disease appear higher than it actually is.
“A significant proportion of the ‘cases’ would never have progressed to invasive breast cancer,” explained Lina S. Mørch, principal investigator and team leader at the Danish Cancer Research Institute, who was not involved in the Swedish study. He added that it would be prudent to wait for more data distinguishing between early and advanced cancers before issuing new recommendations for specific hormones.
conversation between doctor and patient
Although scientists debate how to interpret the study’s specific details, doctors emphasize that the study reinforces what they already frequently discuss in consultations: that for most patients, hormonal contraceptives are generally safe and that decisions should be made based on each woman’s needs and values.
Katharine White, chief of obstetrics and gynecology at Boston Medical Center, said the study will not change how she counsels patients.
“When I counsel patients about contraceptive options, I focus on what is important to them regarding their prior experience, medical history, contraceptive methods, and pregnancy plans (if applicable),” she wrote in an email. “Side effects and risks are already a core part of the information I provide about hormonal and non-hormonal methods.”
Other doctors also pointed out that there are options that don’t use hormones.
“For those who prefer non-hormonal birth control, the copper IUD offers a safe, convenient, and highly effective option for more than 10 years and can be easily removed if you wish to become pregnant,” said Eleanor Bimla Schwarz, chief of internal medicine at Zuckerberg San Francisco General Hospital, referring to a type of long-acting intrauterine device.
Mary Rosser, director of comprehensive women’s health at Columbia University Irving Medical Center, said this was a large, high-quality study that looked at different types of hormones over several years. But he also said medical recommendations should not change yet.
Johansson and Hadizadeh emphasized that the results should not be a cause for alarm, but should aid shared decision-making. “Based on our data, it may be reasonable to consider a risk-reducing formula,” they noted.
They noted that while products containing medroxyprogesterone acetate, drospirenone, or levonorgestrel were associated with a lower risk, it may be better to avoid long-term use of desogestrel-only contraceptives if other suitable options are available.
Putting Risk in Perspective
Hormonal contraceptives offer many health benefits beyond preventing pregnancy. It may reduce heavy menstrual bleeding, relieve pain from endometriosis, and lower the risk of ovarian and uterine cancer even years after stopping. Mørch said even small risks should be discussed, but decisions should be made based on each woman’s “values and preferences.”
White emphasized the importance of looking at the big picture. “For people not using contraception, the risk of unplanned pregnancy is as high as 85 percent, so the risks associated with contraception must be weighed against the risk of unplanned pregnancy,” he wrote.
