In general any type of hormonal anything is probably dangerous. Endocrine system is incredibly complex and connected in many different, mostly unknown ways.
And contraceptives play with hormones that are central to what makes women women.
These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation.
I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.
It’s already suspected though not proven (as far as I know) that estradiol increases breast cancer risk, but I imagine most of that is because it encourages significant breast tissue growth.
> In general any type of hormonal anything is probably dangerous. Endocrine system is incredibly complex and connected in many different, mostly unknown ways.
By that logic sugar should be a controlled substance and we should all be gonadectimized. Gonadectimized animals almost always live longer.
> And contraceptives play with hormones that are central to what makes women women.
Weirdly estrogen in utero is central to what makes male mice male mice, and adult men adult men (20–55 pg/mL estradiol in adult men or about 1/10th the level of adult women). Estradiol plays many important roles in the body of all human adults.
> These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation.
> I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.
Maybe, maybe not, since chronic use of any medication will result in chronic side effects and physical interventions such as copper IUDs are also associated with a host of serious side effects. The best course of action would be to develop interventions that are safe in animal models, give them to humans for a while, and monitor the outcomes, which is what is going on here.
I'm surprised that the outcomes observed aren't worse, given how strongly carcinogenic estrogens are on a dose-dependent basis in animal models. Hormones are strange. Women with many children have reduced amounts of breast cancer despite being exposed to absolutely enormous levels of estrogens and progesterone during and after pregnancy.
Statistically significant, but slight (~25% increased risk, on average.) Still not great.
Obviously, copper IUDs are an alternative for many, though they have their downsides. One of the big uses of hormonal contraception is managing heavy periods, PMDD and other medical conditions. I had a friend who would throw up for days every time she was on her period. It went away pretty completely on birth control.
The magnitude of risk increase in percentage has to be understood in context of baseline probability.
25% additional chance of getting hit by lightning and 25% additional chance of getting heart disease are two completely different results -- I don't mind the first but I would be scared by the second.
About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer.
> About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer.
The study didn’t measure lifetime risk, so your assertion is not correct. It measured risk of acquiring breast cancer before age 49. This is not the age when most women get breast cancer. Average age of onset for breast cancer in the US is 62.
Every single girlfriend I had, I asked her to get off contraceptives because of the medical dangers and I didn't want to be responsible for any problems associated with it. Instead I took responsibility for making sure she wouldn't get pregnant. One of my girlfriends actually got mad at me because I was *too* careful about getting her pregnant, and interpreted that as me not wanting to get married to her (which since we're not together ended up being true I guess).
This doesn't work for everyone but I'm fairly responsible, and no accidental pregnancies, so it worked for everyone I was with. The same way went for my wife as well, and we have 2 kids now, with no accidentals ones. I'm going to teach my son this as well, that the responsibility is on both parties but as the man you need to control what you can control and don't leave things to chance, especially something as life changing/destroying as an accidental pregnancy.
Wow. I'd probably break up with a guy who "asked me to get off contraceptives". If you want to be responsible about preventing pregnancy, that's fantastic. If you feel like that's any more than an input to her decision of whether to be on it, that's a pretty fundamental overreach.
Maybe I'm being overly generous, it seems like it may be possible for this kind of thing to be more of a request out of support/concern for a loved one's health, rather than one of control or knowing better than a woman. It has been my understanding that many men don't consider such things.
My lady has had horrendous experiences with hormonal contraceptives. Based on what we know of it, if she ever expressed wanting to try it again, I'd ask she reconsiders, or that we explore other options. She would appreciate that as being thoughtful (not as me claiming to know what's better for her, better than herself.)
Meh. It's not particularly controversial so you're being overly dramatic.
I didn't force anyone, we had an adult conversation about it and all my gfs were on the same page. If any one of my gfs wanted to stay on contraceptives in the first place, then great, I would still do the exact same thing to avoid getting her pregnant in case she missed a day, etc. My wife wasn't on contraceptives in the first place so it was basically a non-conversation.
I think having an adult conversation is basic expectations for any healthy relationship. If you interpret broaching a subject as being cause for breaking up with someone... well, that's your prerogative.
Why does it upset you that GP would be concerned for his GF's health? I also ask my GF's not to take oral contraceptives because of guilt that they're doing damage to their body for me. None have ever responded negatively, and at the end of the day it was a request. All agreed they did not feel great when taking the pills, but continued because of pressure by society/previous partners.
I see your point but I think the parent didn't mean "ask" as in "told", it's obvious (at least to me!) that such decisions are taken by the woman only. I interpret this as, "I take the full responsibility for not making you pregnant. You can relax now and you don't need to increase the risk of getting cancer out of fear of pregnancy."
In relationships, all "asks" are a smidge more than "just an input" that have to be negotiated with diplomacy or you'll probably end up alone a lot
From medicines, to exercise, vaccines, going to GP, having more serious procedures, going to bed on time... contraceptives, condoms, vasectomy, pregnancy... tattoos, piercings... paying bills, mortgage, savings, joint/split accounts... partners will give inputs on everything. There is no overreach. Strange would be if they didn't worry about each other and the family future
You will always have the last say about yourself, but you will also be mad when your partner ignores something you think you're righter
Especially if you end up having children together and cannot handle disagreements on what best for their health and life in general
To be clear: you would never be in any way responsible for problems associated with your partner taking hormonal birth control because it is a choice they make themselves for their own body.
> Instead I took responsibility for making sure she wouldn't get pregnant
You have to understand what a big statement that is. If she does get pregnant there’s only one person guaranteed to have to deal with the consequences of that, and that’s her. Being hesitant to transfer the responsibility to you is very rational, being mad at you over the topic is understandable.
I know your intention is good throughout here but there’s an implication that you know what’s better for their bodies than they do. A better approach (IMO) is to inform them of the risks (which you’re right they may not know) and let them make their own choice.
You are getting weird hate here. You identified a health risk someone you cared about / loved was taking and strongly encourage them to avoid it (and offered other solutions)
This is exactly what a proper partner does. Obviously you didn't force anyone to do it, but being passionate about such a topic is totally valid.
Your story reminds me of mine though - encouraged female friends to avoid the pretty obvious health risk. And also have two kids now and never before :)
Yeah--there's a factor here that messes up the data. Namely, that pregnancy to term is associated with a *reduction* in breast cancer, the earlier the pregnancy the bigger the effect.
This is the reason behind the "pro-life" claim that abortion causes breast cancer--no, it simply doesn't provide the protection. Never-pregnant vs had-abortion is the same risk. Hormonal contraception is more effective and will reduce the oops rate and thus would be expected to show a positive correlation with breast cancer.
(And the oops rate is also why for a young non-smoker the risk of the pill is *negative* even if the response to an oops is an immediate abortion. Carrying it to term increases the effect by at least an order of magnitude.)
> These calculations were then adjusted to take into account established risk factors such as body mass index (BMI), number of recorded births, and the time since a woman’s last birth.
> The researchers also note that although these findings provide evidence about the short-term associations between hormonal contraceptives and breast cancer risk, they do not provide information regarding longer-term associations, or the impact of total duration of contraceptive use on breast cancer risk, since information on a woman’s prescription record prior to joining a participating GP practice would not have been available within the CPRD database.
Hopefully soon, doctors that prescribe birth control for things unrelated to birth control will now stop doing that as that's a reasonably bad thing to do (IMHO IANAD)
I mean, this isn’t new information for doctors. It’s a pretty well known fact that estrogen agonists can increase risks for breast cancer - that’s why decisions made about birth control are patient centric and consider the patients risk factors.
For reference, risks of breast and cervical cancers are increased in women who use oral contraceptives, whereas the risks of endometrial, ovarian, and colorectal cancers are actually reduced.
Birth control is sometimes prescribed to help with heavy period flow, which could be a symptom of a much worst issue (endometriosis). But birth control is also prescribed to help control acne, which in my humble, unprofessional opinion is not a good use, and the risks far outweigh the benefit. Weight loss is another reason it's prescribed. These sorts of off-label perscription for a hormone are not... great IMHO.
Are there other solutions to acne, and weight loss? Yes. Endometriosis is far more complicated.
After I had the kids I wanted, I got a vasectomy. It’s a painless and quick and largely reversible procedure with no side effects and offers 100% contraception. If you care about your partner and are “done,” I highly recommend it.
> The early failure rate of vasectomy (presence of motile sperm in the ejaculate at 3–6 months post-vasectomy) is in the range of 0.3–9% and the late failure rate is in the range of 0.04–0.08%.
8 out of 10,000 men is still a very low failure rate, although keep in mind that typically failure rates for contraceptives/sterilization are per annum.
So if you get a vasectomy with a 0.08% failure rate and then have sex for 30 years ... 0.08% * 30 = 2.4%.
Considering that one would have to get the hormonal IUD replaced (painful!!) every 3-8 years [1], while vasectomies only require check-ups two times after the procedure (not painful) after 1-2 months, and at one's discretion afterwards, that's a way better value proposition.
Thanks for sharing your positive experience - it's great to hear that the procedure was painless and quick, and has given you and your partner a reliable form of contraception. More important, having a close person in your life whom you can trust is truly a life jackpot! In the current "epidemic of loneliness," it's more important than ever to have strong personal connections.
I certainly didn’t say anything to preclude that. In fact unless the woman is certain of the man, she should control her own contraception. The consequence of a mistake falls disproportionately on her and, well, men are pretty much all assholes, even the well intentioned ones. My message, though, was for men - not for women. Vasectomies are a man’s choice, and the only one we can make that fully insulates the woman in our life from the consequences of sex. Any other measure a man can take is pretty poor in it’s effectiveness.
Yes. Upshot was usually reversible but with reduced fertility, but even when not IVF works because machinery still works and you can clear some sperm even if not successful. So, yes, I waited until I was “done,” and that’s probably the right way to treat it. But even so you could still have kids even in the worst case with some science assist.
The headline is somewhat deceptive. This study doesn’t assess lifetime risk, just risk before age 49. Since most breast cancers are diagnosed well after age 49, it needs to be assessed in that light.
Readit News
And contraceptives play with hormones that are central to what makes women women.
These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation.
I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.
By that logic sugar should be a controlled substance and we should all be gonadectimized. Gonadectimized animals almost always live longer.
> And contraceptives play with hormones that are central to what makes women women.
Weirdly estrogen in utero is central to what makes male mice male mice, and adult men adult men (20–55 pg/mL estradiol in adult men or about 1/10th the level of adult women). Estradiol plays many important roles in the body of all human adults.
> These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation.
> I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.
Maybe, maybe not, since chronic use of any medication will result in chronic side effects and physical interventions such as copper IUDs are also associated with a host of serious side effects. The best course of action would be to develop interventions that are safe in animal models, give them to humans for a while, and monitor the outcomes, which is what is going on here.
I'm surprised that the outcomes observed aren't worse, given how strongly carcinogenic estrogens are on a dose-dependent basis in animal models. Hormones are strange. Women with many children have reduced amounts of breast cancer despite being exposed to absolutely enormous levels of estrogens and progesterone during and after pregnancy.
Your response to hormonally induced cancer is extinction?
Babies and bathwater.
Obviously, copper IUDs are an alternative for many, though they have their downsides. One of the big uses of hormonal contraception is managing heavy periods, PMDD and other medical conditions. I had a friend who would throw up for days every time she was on her period. It went away pretty completely on birth control.
25% additional chance of getting hit by lightning and 25% additional chance of getting heart disease are two completely different results -- I don't mind the first but I would be scared by the second.
About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer.
The study didn’t measure lifetime risk, so your assertion is not correct. It measured risk of acquiring breast cancer before age 49. This is not the age when most women get breast cancer. Average age of onset for breast cancer in the US is 62.
This doesn't work for everyone but I'm fairly responsible, and no accidental pregnancies, so it worked for everyone I was with. The same way went for my wife as well, and we have 2 kids now, with no accidentals ones. I'm going to teach my son this as well, that the responsibility is on both parties but as the man you need to control what you can control and don't leave things to chance, especially something as life changing/destroying as an accidental pregnancy.
My lady has had horrendous experiences with hormonal contraceptives. Based on what we know of it, if she ever expressed wanting to try it again, I'd ask she reconsiders, or that we explore other options. She would appreciate that as being thoughtful (not as me claiming to know what's better for her, better than herself.)
Maybe it's all about context, I'm not sure
I didn't force anyone, we had an adult conversation about it and all my gfs were on the same page. If any one of my gfs wanted to stay on contraceptives in the first place, then great, I would still do the exact same thing to avoid getting her pregnant in case she missed a day, etc. My wife wasn't on contraceptives in the first place so it was basically a non-conversation.
I think having an adult conversation is basic expectations for any healthy relationship. If you interpret broaching a subject as being cause for breaking up with someone... well, that's your prerogative.
From medicines, to exercise, vaccines, going to GP, having more serious procedures, going to bed on time... contraceptives, condoms, vasectomy, pregnancy... tattoos, piercings... paying bills, mortgage, savings, joint/split accounts... partners will give inputs on everything. There is no overreach. Strange would be if they didn't worry about each other and the family future
You will always have the last say about yourself, but you will also be mad when your partner ignores something you think you're righter
Especially if you end up having children together and cannot handle disagreements on what best for their health and life in general
Dead Comment
> Instead I took responsibility for making sure she wouldn't get pregnant
You have to understand what a big statement that is. If she does get pregnant there’s only one person guaranteed to have to deal with the consequences of that, and that’s her. Being hesitant to transfer the responsibility to you is very rational, being mad at you over the topic is understandable.
I know your intention is good throughout here but there’s an implication that you know what’s better for their bodies than they do. A better approach (IMO) is to inform them of the risks (which you’re right they may not know) and let them make their own choice.
But not a choice made in a vacuum. It's a choice made in the context of their relationship.
Don't get that, in most jurisdictions there is an almost guaranteed second one?
This is exactly what a proper partner does. Obviously you didn't force anyone to do it, but being passionate about such a topic is totally valid.
Your story reminds me of mine though - encouraged female friends to avoid the pretty obvious health risk. And also have two kids now and never before :)
Am surprised only one did.
I'm quite surprised how well this works but we are in a stable relationship.
With or without plan b it would not be the end of our life's if we would suddenly getting a child.
Not sure how I would see it if I would be 20 and not above 30
Deleted Comment
chivalrous, even.
/s
Any type of hormonal contraceptive is associated with an increased risk of breast cancer.
This is the reason behind the "pro-life" claim that abortion causes breast cancer--no, it simply doesn't provide the protection. Never-pregnant vs had-abortion is the same risk. Hormonal contraception is more effective and will reduce the oops rate and thus would be expected to show a positive correlation with breast cancer.
(And the oops rate is also why for a young non-smoker the risk of the pill is *negative* even if the response to an oops is an immediate abortion. Carrying it to term increases the effect by at least an order of magnitude.)
> These calculations were then adjusted to take into account established risk factors such as body mass index (BMI), number of recorded births, and the time since a woman’s last birth.
Is it the same as yours?
For reference, risks of breast and cervical cancers are increased in women who use oral contraceptives, whereas the risks of endometrial, ovarian, and colorectal cancers are actually reduced.
Also IANAD
Are there other solutions to acne, and weight loss? Yes. Endometriosis is far more complicated.
> The early failure rate of vasectomy (presence of motile sperm in the ejaculate at 3–6 months post-vasectomy) is in the range of 0.3–9% and the late failure rate is in the range of 0.04–0.08%.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110415/
8 out of 10,000 men is still a very low failure rate, although keep in mind that typically failure rates for contraceptives/sterilization are per annum.
So if you get a vasectomy with a 0.08% failure rate and then have sex for 30 years ... 0.08% * 30 = 2.4%.
Typical hormonal IUD annual failure rate = .1% [1].
.1% * 30 years = 3%.
Considering that one would have to get the hormonal IUD replaced (painful!!) every 3-8 years [1], while vasectomies only require check-ups two times after the procedure (not painful) after 1-2 months, and at one's discretion afterwards, that's a way better value proposition.
What did your doctor tell you about reversibility?