Several recent scientific studies have examined the risks to which women are exposed when taking hormonal contraceptives. Certain studies go deeper into subjects already known to the public and which have been the subject of publications and articles for many years (for a survey by Alliance VITA, click here).
Hormonal contraception and breast cancer
The link between the heightened risk of breast cancer and use of the hormonal pill has been studied and documented for many years. A study published in 1996 in the Lancet had already reported it. The WHO incidentally lists this risk in its classification of carcinogenic products. A new study published last spring has again investigated the subject. It is based on a sample of some 10,000 women living in the United Kingdom and suffering from breast cancer between 1996 and 2017. The main results indicate that the risk of breast cancer increases by 20 to 30% for women using hormonal contraception. This risk is present irrespective of the form of administration of the substance: pill, IUD, implant. According to the authors, their analyses “revealed significantly high relative risks (RR) for the current or recent use of progestative contraceptives alone”. Another result of this research, the risk of cancer is confirmed irrespective of the formula used, progestative or an oestroprogestative combination. The study examined the link in the “short term” between the use of contraception and the development of breast cancer. It does not provide any information on the long term risks nor on the impact of the duration of the use of hormonal contraception.
According to the National Cancer Institute “breast cancer is the cancer most frequently observed in women in France, as well as in the European Union and the United States. The number of cases recorded each year has tended to diminish since 2005, even if this disease remains the main cause of death by cancer in women in 2023”. In France there are around 60,000 new cases recorded each year. In 2018, 12,100 women died from breast cancer. The risk of contracting breast cancer increases with age and there are other causes than the use of hormonal contraception.
The study, as well as the WHO web-site, indicate also that certain types of hormonal contraception have a protective effect on other forms of cancer. Several studies suggest in fact that women on the combination pill have a lower risk of contracting ovary or endometrium cancer. However, neither the study, nor the WHO web-site, provide any quantified data on this protection. The prevalence of these cancers is considerably less. Whereas one in 8 women in France contract breast cancer, ovarian cancer affects a mere one in 70. According to the Revue du Praticien (Practitioner’s Review), the incidence of cancer of the body of the uterus is 7 times less than that of breast cancer: 8,224 cases in 2018 compared with 58,459 cases of breast cancer.
The pill and its impact on mental health
Various studies have also examined the possible links between mental health and the use of oral contraception. In 2016, a study based on over a million women in Denmark concluded that “The use of hormonal contraception, in particular by adolescents, has been linked to the subsequent use of antidepressants and to an initial diagnosis of depression, suggesting that depression is a potential undesirable effect of the use of hormonal contraceptives”. A new study published in June 2023, and based on over 260,000 women in the United Kingdom, confirmed these results. The authors aimed in particular to measure the “bias” due to the fact that women ceased their hormonal contraception when they felt an effect on their temperament. This behaviour leads to underestimating the impact of hormonal contraception on the risk of depression. Overall, the authors confirmed the previous results: “Our results suggest that the use of oral contraceptives, in particular during the first 2 years, increases the risk of depression. Furthermore, its use during adolescence could increase the risk of depression in later life.”
An even more recent study, published in August 2023, examined the link between use of the hormonal contraceptive pill and the control of stress. On a small sample of 131 young women, the authors measured the presence in the blood of a hormone (ACTH adenocorticotrope hormone) which itself acts on the production of the hormone cortisol, which is itself involved in the regulation of stress. The study measured the presence of the ACTH hormone before and after group activities (such as board games, choir singing etc.) whose effect is generally to reduce stress levels. The authors concluded that there is an “impact of oral contraception on a dynamic modification of the response to stress” and call for further studies.
This panorama of recent research underlines the impact of the use of hormonal contraception on the health of women. Widespread dissemination of this information to the general public should be part of the public health policy, especially as the public authorities promote hormonal contraception in particular through its availability free of charge up to 25 years of age, introduced in January 2022. A more ecological approach incorporating respect for the natural biological and hormonal bodily functions could also be included in the public authority campaigns on the subject of contraception.