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Caution Advised for Women Who Use Oral Contraceptives
By Corrie Driebusch, Gilbert Ross, M.D.
A new study by Belgian researchers found that taking oral contraceptives increases a woman's risk of atherosclerosis. A preliminary report of a study presented at the American Heart Association meeting indicated a small increase in the occurrence of fatty deposits in the arteries of the women studied, as evaluated by sonograms of the carotid and femoral arteries. The authors, led by Dr. Ernst Reitzschel, found that among 1,300 healthy women who had been on hormonal contraception for a mean duration of thirteen years, there was a 20-30% increase in prevalence of arterial plaque for each ten-year period of pill use.
The bad news, apparently, keeps coming. Last month women heard they shouldn't drink more than a glass of wine a day to avoid (supposedly) increasing their risk of breast cancer. Then, we hear red meat must be taken off the table, too. Now, the Pill is purportedly off limits, lest women incur a higher risk of developing artery-clogging plaque. When will it all stop?
As Salon.com summed up so nicely, this study raises women's fears about health research and shows the "difficulties of navigating the waves of information that wash over us daily."
Similar to the studies on alcohol and red meat, both of which the media made seem scarier than they really are, this research on the Pill should not cause alarm. For starters, the alleged risk increase is only 20-30%, and in an uncontrolled study like this one, such a small increase is highly unlikely to be an actual cause and effect. And these were only ultrasound findings -- no actual heart attacks or strokes were detected. The final sigh of relief can be exhaled when we consider that the oral contraceptives studied were from more than a decade ago -- back when estrogen levels used in the pills were much higher than they are today.
The Pill increases risk for heart disease? The stress of dealing with these fear-inducing studies may increase risk more. Still, women who want to plan their families should consider using a barrier method, meaning condoms, along with hormonal prevention. Also worth consideration: an IUD (intra-uterine device) has been shown to be safe and effective in most women. Whether this method affects risk of cervical cancer is not yet known. And cervical cancer, unfortunately, was the threat at the center of the week's second piece of disturbing contraceptive news.
Cervical Cancer Risk?
Now comes a meta-analysis (a study combining the results of many other studies) from the journal The Lancet, which describes the impact of combined oral contraceptives on risk of cervical cancer. This study, analyzing twenty-four studies involving over 16,000 women with cervical cancer, compared to over 35,000 women free of the disease, found that for women who currently use birth control pills for at least ten years, the relative risk of invasive cervical cancer was almost doubled. The risk was also elevated for those who used the Pill for lesser periods of time but not as much. This study's authors are a multinational group known as the International Collaboration of Epidemiological Studies of Cervical Cancer.
This report is important because cervical cancer is the number two cancer killer in the developing world, and the most common cause of cancer death among women aged twenty-five to sixty-four in many poorer areas. This is why the research, development, and marketing of the new cervical cancer vaccines, along with increased attempts at screening, are so crucial to saving more women from premature cancer death. Still, preventing unintended pregnancy is also important -- such pregnancies are often complicated and result in both neonatal and maternal death. The increased availability and use of barrier contraception would be a good solution.
Gilbert Ross, M.D., is Medical and Exective Director of and Corrie Driebusch a research intern at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
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