Kinsey Confidential

Question:\nI'd like to get on the pill but I've heard mixed things about it. Is it true that it causes cancer?\nAnswer:\nThere has been a great deal of research on various types of oral contraception (OC; also called the birth control pill or "the pill") since it first became available in the U.S. in the 1960s. First, we should say that early versions of OCs contained much higher doses of estrogen and progestin than the pills currently on the market. In addition, keep in mind as you read this that most research involves women taking combination (estrogen/progestin) pills, which are more popular than the progestin-only pills. That means that we have more information about combination pills and women's health than we do about other methods.\nResearch shows that women who have used OCs have a lower risk of ovarian cancer than women who have never taken OCs. However, it's less clear to what extent the pill reduces risk for women with a strong family history of ovarian cancer. \nOC use also reduces the risk of endometrial cancer by about 50 percent. Endometrial cancer is the most common cancer of women's reproductive organs (the endometrium is the lining of a woman's uterus). As with ovarian cancer, this benefit may last for years after stopping OC use. \nThe risk of colorectal cancer appears to be lower among women pill-users, but more research is needed to understand this relationship, the degree of protection and how long it lasts.\nThe relationship between OC use and breast cancer is unclear. Early research suggested pill use increased women's chances of getting breast cancer, but the women in those studies also had taken the earlier versions of OCs, which were higher in hormones. More recent research has not found a material increase in breast cancer risk; however, it may pose an increased risk for women with other high-risk factors (like having a family history of breast cancer). If you have concerns about your own risk for breast cancer (or you family's health history), you should discuss them with your health care provider.\nResearch findings are also unclear when it comes to cervical cancer. Some research has found an association between OC use (particularly long-term use) and certain kinds of cervical cancer, but other research has not. If you're concerned about your risk for cervical cancer, let your health care provider know. He or she can counsel you about other ways to reduce your risk, like limiting your number of sexual partners (reduces risk of HPV, which is related to cervical problems and cancer), not smoking and getting regular Pap tests. Thanks to Pap tests (which screen for cervical changes), cervical cancer rates have declined in the United States.\nThe decision to start a birth control method is a very important one, and talking with your health care provider is a great way to get accurate information that's relevant to you. It's also a good opportunity to learn about other ways you can enhance your health related to your diet, exercise, annual gynecological exams, breast and vulvar self-examinations, smoking/drinking habits and more. \nSome things -- like your age, weight, smoking history, sexual practices, family history of heart or cancer problems -- may influence which birth control method your health care provider recommends. Hormonal methods (like the pill, patch, shot and vaginal ring) are highly effective at preventing pregnancy, but they don't offer any protection against sexually transmitted infections. Condoms (when used correctly and consistently) and abstaining from genital contact with a partner offer far better protection against STIs. Finally, a good method of birth control will be one that you use correctly and consistently. The pill is a great choice, but not if you think you might forget to take it on time. You can learn more about contraceptive choices on the KISISS web site www.indiana.edu/~kisiss