The risks of the pill are small… no need to panic, writes consultant OB/GYN DR SHAZIA MALIK
The first thing I would say is ‘Don’t panic’. The headlines may sound alarming, but when you look at the numbers, it’s clear that your risk of breast cancer before age 50 remains low, regardless of which method of birth control you’re taking. And in your 20s and 30s, it’s minuscule.
The important thing to remember when reading cancer risk statistics like these is that the increases are expressed as percentages of existing numbers that are, in fact, very low.
The chance of a 30-year-old woman developing breast cancer in the next ten years, for example, is less than one percent, so a 26 percent increase in that — the increase associated with taking the pill. progestin-only for five years. in this study, it will remain small. The figure for a 40-year-old woman is about 1.6%, so if her risk is also increased by 26%, instead, she’s looking at an overall risk of 2%. Still very small.
I’m surprised we haven’t looked at progestin-only contraception in such depth until now, but I don’t think we can chalk it up to a more general neglect of women’s health. For years, we’ve simply focused on estrogen as a potential risk factor for breast cancer, but now we know that’s only part of the picture.
Research is also catching up with changing prescribing trends. In the last ten to 15 years, women have increasingly stopped using the combined estrogen-progestin pill, largely because of unwanted side effects, and have turned instead to progestin-only contraceptives. Today almost as many women in the UK take the progestogen-only mini-pill as the combined pill.
DR SHAZIA MALIK: The first thing I would say is ‘Don’t panic.’ The headlines may sound alarming, but when you look at the numbers, it’s clear that your risk of breast cancer before age 50 remains low, regardless of which method of birth control you’re taking. And in your 20s and 30s, it’s minuscule (Pictured Consultant OB/GYN Dr. Shazia Malik)
The important thing to remember when reading cancer risk statistics like these is that the increases are expressed as percentages of existing numbers that are, in fact, very low (file photo)
What surprises me is the finding in this study that the risk of the progestin-releasing coil is greater than that of the combined or progestin-only pill. We don’t understand that at all, since circulating hormone levels are much lower with a coil than with oral contraception. In theory, the risk should also be lower. It is an anomaly that needs to be investigated.
What is undeniable is that the pill and the coil in all its forms can have a hugely beneficial impact on a woman’s quality of life in her reproductive years. Doctors see the relief they provide every time. They can put an end to the misery of heavy, debilitating periods or chronic pelvic pain and, of course, prevent unwanted pregnancies. Especially important is that hormonal contraception has reversed the high pregnancy rate we used to see in adolescents. Breastfeeding mothers can use the progestogen-only pill or coil, and the combined pill is known to reduce the risk of ovarian, endometrial, and colon cancer.
It would be a tragedy if all the gains of hormonal contraception were undone because women are afraid of what is still a small risk.
Research is also catching up with changing prescribing trends. In the last ten to 15 years, women have increasingly stopped using the combined estrogen-progestin pill, largely due to unwanted side effects, and have turned instead to progestin-only contraceptives (photo from archive)
To me, this study is only one piece of information that can be used in advising women on which form of contraception is best for them. It is vital to treat women as individuals and assess their lifestyle and general health before helping them make a decision. Since 2021, the progestogen pill can only be purchased in pharmacies without a prescription, giving pharmacists a crucial role in women’s reproductive health as well.
Breast cancer in young women is still not well understood. But if a woman is concerned about her risk, there are things she can do, such as not drinking more than one unit of alcohol a week, watching her weight, and trying to breastfeed if she has a baby, a known protective effect. Women should not be alarmed, but should work with a GP, family planning clinic or gynecologist to give themselves the best chance of getting what they want out of their childbearing years, family or not.
