Hormonal Birth Control and Breast Cancer
- Studies have shown that the classic birth control pill may come with a slight increase to the risk of breast cancer.
- But a recent study found that all forms of hormonal birth control, no matter the method, comes with the same increase to breast cancer risk.
- Our experts stress that this risk is small, and people should weigh the benefits of these birth control methods against the slight risk with their doctors.
- Studies have shown that the hormone-coated IUD helps to lower the risk for uterine, endometrial and ovarian cancers.
Contraception, also called birth control, prevents a pregnancy before it begins. The majority of American women ages 18-64 (90%) have used birth control at some point in their reproductive years. In fact, almost three quarters of women in the U.S. have tried more than one contraceptive method throughout their lifetime.
Read More"As in all thinking in medicine, there is always risk-benefit to consider," says Dr. Dana Chase, an associate professor of UCLA Obstetrics and Gynecology in the Division of Gynecologic Oncology. "There should be a discussion with a [health professional] or physician about what's best for you.”
Here’s everything you need to know.
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What Is Hormonal Birth Control?
Hormonal birth control method of birth control that uses hormones to prevent pregnancy. Hormonal contraceptives contain either a combination of estrogen and progesterone, or progesterone only.
"Hormonal contraception prevents pregnancy by blocking the release of eggs from a woman's ovaries, thinning the lining of her uterus, or thickening the mucus in the cervix to help keep sperm from reaching the egg," Dr. Chase, a board-certified gynecologic cancer physician and surgeon, told Surivornet during a telephone interview.
Hormonal Birth Control Options
There are several different types of hormonal birth control options, which pepole can choose with their doctor depending on your personal preferences and unique circumstances. Those options include:
Swallow it in pill form. Most people in the U.S. who are on the pill take what's called the combination pill. Estrogen and progesterone stop your ovaries from releasing eggs and they make changes in your cervix and uterus that lower your chance of pregnancy.
Have an injection. This method prevents pregnancy by injecting a synthetic version of the hormone progestogen, called Depot medroxyprogesterone acetate, or DMPA. It keeps the body from producing its own hormones and releasing eggs from the ovaries.
Get an implant. The contraceptive implant (commonly sold unde the brand name Nexplanon) is a small flexible plastic rod that's placed under the skin in your upper arm by a health professional. It releases the hormone progestogen into your bloodstream to prevent pregnancy and will last for three years.
Use a skin patch. The patch releases a daily dose of hormones through the skin into the bloodstream to prevent pregnancy. It contains the same hormones as the combined pill estrogen and progestogen and works in the same way by preventing the release of an egg each month (ovulation).
Insert a ring in the vagina. The vaginal ring (commonly sold under the brand name NuvaRing) is a small, soft, plastic ring that you place inside your vagina. It releases a continuous dose of hormones estrogen and progestogen into the bloodstream.
Have an IUD placed in your uterus. This device is a T-shaped plastic frame that's inserted into the uterus by your HCP, where it releases the hormone progestin.
But no matter the method you choose, Dr. Dweck has an important note.
"I want to stress that no matter what type of delivery you choose, hormonal contraception is not appropriate for women with breast cancer," says Dr. Dweck. "That said, there are several options for the delivery of this type of birth control. Keep in mind that no matter how it's delivered to your body, all hormonal contraceptives are highly effective when used as directed,"
Dr. Dweck adds: "Thoughtful decision-making among patient, partner (if there is one) and your [health professional] is the first step."
What’s the Risk of Breast Cancer With Hormonal Birth Control?
The new U.K. study found that women 50 years or younger who took any type of hormonal contraceptives increased their risk of breast cancer. Researchers from the University of Oxford came to this conclusion after analyzing data from the U.K.'s primary care data base, which included 10,000 women.
Among this population, there was an increase in risk regardless of how the contraception was delivered whether by pill, implant, intrauterine device, vaginal ring, IUD or skin patch. The study also found that the combinations or hormones doesn’t matter whether the hormonal contraception is a combination of progestin and estrogen, or progestin alone.
But Dr. Chase points out that the risk itself is small.
And statistically speaking, it’s a good idea to keep the study's results in perspective. The 15-year risk indicating the likelihood of getting breast cancer from hormonal contraception is:
- 1 in 12,5000 for women from the ages of 16 to 20.
- 265 in 100,000 women from ages 35 to 39.
The study also found a slight increased risk for woman as they aged.
On the other hand, the researchers noted that the longer a woman is off hormonal birth control, the lower her risk for developing breast cancer.
Should You Remove or Stop Taking Your Hormonal Birth Control?
Both doctors Chase and Dweck agree that there's no reason to panic or stop taking your hormonal birth control.
"As in all thinking in medicine, there is always risk-benefit to consider," says Dr. Chase. "There should be a discussion with a [health professional] or physician about what's best for you. If you are not ready to have children and/or experience life-altering menstrual cycles that compromise your quality of life (which hormonal contraceptives can control), a slight increase of breast cancer risk may not be a big deal. This is especially true when you can't have a good life without some kind of birth control method that regulates hormones."
But Dr Chase adds, "If you're taking this medication, be sure to have routine mammograms. "Also, if you have a strong family history of breast cancer and you're taking medication for contraception or to control menstruation, speak with a genetic counselor or your primary care physician to find out the potential for your increased risk of breast cancer."
Dr. Dweck points out that there are also other factors to consider. The risk of breast cancer also increases:
- If you started menstruating earlier and were therefore exposed to estrogen earlier (Menstruation typically begins between 10 and 16)
- If you've never given birth to children or breast fed
Benefits of Hormonal Birth Control
While the slight risk of breast cancer is important information to have when considering which birth control method to choose, Dr. Chase says there are “absolutely” benefits of hormonal birth control to consider as well.
The hormone-coated IUD is known to lower the risk for uterine, endometrial and ovarian cancers.
"The incidence of uterine cancer is on the rise, especially in obese women," Dr. Chase points out. "That's because fat in the body has an enzyme that converts androgyn to estrogen. It's thought that this process contributes to cells in the uterine lining to proliferate. But studies have shown that an hormone- coated IUD helps to prevent the disease."
When it comes to cervical cancer, the latest research suggests the benefit is significant. The IUD may reduce the risk of developing cervical cancer by as much as 30%.
No-Hormone Birth Control Options
Deciding on the best birth control plan can be challenging. Speak with your healthcare provider about the non-hormonal method that may be best for you. Here are your options:
Diaphragm. This is a silicone cup placed in the vagina to block semen from entering the womb. It needs to be fitted by a health professional.
Cervical cap. Made of silicone into the shape of a hat, the device is placed over the cervix to keep out sperm. You can buy this method, which already contains spermicide, without a prescription.
Sponge. Made of foam, it works the same way as a cervical cap or diaphragm. The sponge already contains spermicide and you can also buy it without a prescription.
Copper IUD. The health care provider places an IUD inside a woman's uterus. Copper IUDs are typically made of plastic with some portions covered with copper which is toxic to sperm. The IUD also prevents sperm from swimming through the vagina to reach the egg. If that fails, it prevents the fertilized egg from attaching to the womb.
Spermicides. You can buy spermicides over the counter in different forms including gels, foams and suppositories. It works by killing or paralyzing the sperm.
Vaginal gel. The gel is inserted in the vagina before having sex by using an applicator. It works by keeping the pH level in the vagina from rising and allowing the sperm to move to the reproductive canal to reach the egg.
Male condom. This is a thin sheath that can be made of latex or sheepskin. A man wears it over his penis during sex to keep semen from getting into a woman's body.
Female condom. This is a lubricated latex tube with flexible rings on both sides that is slipped into the vagina. One end of the condom is closed to keep out sperm.
Surgical methods. These are known as sterilization surgeries. There are two kinds:
- For women – tubal ligation, which blocks a woman's fallopian tubes to prevent an eff from reaching her uterus.
- For men – vasectomy, which seals the tubes that carry sperm out of a man's testes.
Behavioral methods:
- Outercourse, in which the man's penis doesn't go into the woman's vagina at all.
- Withdrawal or "pull-out" methods, in which the man "pulls out" of the vagina before he ejaculates.
Natural family planning. This method works when a woman tracks her menstrual cycle including her vaginal discharge and body temperature, so she can know which days she's fertile.
Other Ways to Reduce the Risk of Breast Cancer
"By making certain lifestyle choices, you can reduce your risk of getting the disease," Dr. Dweck says. She suggests these hat tricks:
- Keep a healthy weight
- Be physically active
- Choose not to drink alcohol or drink alcohol in moderation
Here's the takeaway:
Dr. Chase points out that messages from the medical community can be confusing, especially when it comes to women's issues and cancer. "That's why patients should have a discussion with their healthcare provider to assess the risks and benefits of any form of birth control. If you're taking hormonal contraception, unless you've been diagnosed with breast cancer or have other serious risk factors that were previously mentioned, you probably do not need to change your approach. However, you need to get routine breast cancer screenings."
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