Why Your Ovaries Heart The Pill

Birth-Control
 
 

Hello again, dear readers, and welcome to today’s installment of my series debunking 1Flesh’s lies and propaganda. Today we’ll be talking about how the Pill actually DOES reduce a woman’s risk of developing ovarian cancer, in a very real way.

As always, paragraphs in italics are taken directly from 1Flesh’s site.

Enjoy!

The Pill And Ovarian Cancer

Patients are often told by their doctors that the Pill can reduce a woman’s risk of ovarian cancer by 52%.

Not that I’m doubting you here 1Flesh (oh, who are we kidding, I am doubting this statement), but could you please provide a source?

This can be misleading. First of all, this benefit is not conferred simply by taking the Pill, but by taking it for over 7-8 years.

That? That right there? That’s a straight up lie. From the study:

“Ovarian cancer risk was significantly reduced by 52% for ever use of any type of OC.”

So, no, 1Flesh. Reading studies?

Secondly, the study that found this 52% reduction included women taking high-dose birth control pills, pills that have a greater reduction of ovarian cancer risk (Ortho-Novum 1/50 Ovral, Demulen 1/50, Ogestrel, Ovcon 50), but are now the least prescribed pills on the market. And for good reason — high-dose birth control pills have the worst side effects.

First, I can’t even tell you how hard I’m lol-ing at the fact that 1Flesh will take issue with the different generations of birth control pills when it comes to ovarian cancer, but ENTIRELY AND COMPLETELY ignores it when it comes to their analysis of breast cancer.  Instead I’ll just show you:

Second, here’s the full article.

Third, care to tell your readers what the title of this study was? Nah? Okay, I will: Low-dose oral contraceptives: Protective effect on ovarian cancer risk.

The study DID include women taking birth control pills with higher levels of estrogen and higher doses/different variations of progestin, BUT it also included women using low-dose birth control pills (women using birth control pill with 35 μg OR LESS of ethinyl estradiol) because they wanted to see if the benefit existed for low-dose birth control pills, as well.

And what did they find?

“Use of low-dose oral contraceptives only was associated with a more substantial reduction in ovarian cancer risk (OR = 0.24, 95% CI = 0.10–0.55) than use of high-dose OC formulations only (OR = 0.70, 95% CI = 0.43–1.13)”

What does this mean in layperson’s terms? That the researchers found that the HIGHEST risk reduction was found in women using oral contraceptives with LESS THAN 35 μg ethinyl estradiol.

1Flesh, I’m getting really sick of correcting your shoddy research. I’m going to keep doing it, because FACTS MATTER, but it’s really starting to get on my nerves.

Most women are prescribed are low-dose, regular dose or ultra-low-dose birth control pills.

You know, I’m going to go ahead an insert some meanings for these terms you keep throwing around willy nilly, just so we’re on the same page:

First generation OC’s are OC’s containing more than 35 micrograms (μg) of estrogen and more than 2.5 milligrams of progestin. Second generation OC’s contain less than 35 μg of estrogen and less than 2.5 mg of slightly newer progestins like norethindrone or levonorgestrel).

Third and fourth generation OC’s typically contain 20 μg to 30 μg of ethinyl estradiol and much lower levels of newer progestins (from .15 mg of second generation progestins like levonorgestral to .18mg of third generation progestins like norgestimate).

And, just so we’re clear, this study looked at women taking ALL generations of birth control. And, again, it found that women taking OC’s containing LESS THAN 35 μg of ethinyl estradiol (aka third or fourth generation OCs, aka low-dose OCs) had an even LOWER risk of ovarian cancer than women taking earlier generation, aka high-dose, OCs.

When the same study looked at low-dose birth control pills, it concluded that they decreased the risk of ovarian cancer by about 4-5% per year, and thus it takes more than 10 years to achieve that risk reduction of 52%.

Why must you continue to lie? Why? Especially when you’re lying about something that’s so incredibly easy to fact check. Are you wanting to get caught? Do you secretly yearn for it? Or are you just hoping your readers are dumb enough to take anything you say at face value? Sadly, I’m thinking it’s the latter. Which means you’re taking advantage of gullible readers, and endangering lives. Highly unethical and, I’d say, immoral. Strange, coming from a group of kids from a religious college….

What did the study ACTUALLY find?

Then we assessed the risk for ovarian cancer in relation to duration of use of OC formulations with different ethinyl estradiol content. Risk for ovarian cancer was reduced by 5% per year for formulations with 50 μg or more ethinyl estradiol (Table IV) whereas it was 12% per year of use for of OCs with less than 50 μg ethinyl estradiol (data not shown). The decrease in risk was 14% per year of use for OC formulations containing less than 35 μg ethinyl estradiol and 9% per year for OC with 35 – <50 μg ethinyl estradiol.

The FDA packaging contained inside birth control packets admits this: It notes that the decreased incidence of ovarian cancer is a benefit determined by studies that “largely utilized oral contraceptive formulations containing estrogen doses exceeding 0.035 mg of ethinyl estradiol or 0.05 mg of mestranol.”

What in the world did you even link to there? A webpage talking about ONE type of oral contraceptive? In any case, we have JUST SHOWN, IN THIS POST, that the risk reduction exists, and is even GREATER in low-dose oral contraceptives. So…yeah.

A recent, more accurate study published in the European Journal of Cancer Prevention claims: “the overall estimated protection[…]is approximately 30% for ever OC users” and up to 50% for those who use oral contraceptives for more than ten years.

Hmmm…let’s go ahead and share that WHOLE abstract, why don’t we:

The overall estimated protection from cohort and case-control studies is approximately 30% for ever OC users, and increases with duration of use by approximately 5% per year of use to about 50% for long-term (≥10 years) users. The favourable effect of OC against ovarian cancer risk persists for at least 20 years after OC use has ceased, and it is not confined to any particular type of OC formulation. The reduced risk among OC users is observed in women without or with family history or genetic predisposition to ovarian cancer, and for most histological types of epithelial ovarian cancer, although the pattern of risk is less consistent for mucinous than for other types. The protection of OC on ovarian cancer risk, also in view of its long-term persistence, corresponds to the avoidance of 3000-5000 ovarian cancers (and 2000-3000 deaths) per year in Europe, and a similar figure in North America.

That sounds a bit better, doesn’t it.?

This is still a significant reduction of risk, and certainly not a benefit to be scoffed at, especially considering that this protection continues long after the use of oral contraceptives.

Yes, according to the study you cited in the previous paragraph, the risk reduction persists for at least 20 years after OC used has ceased.

Unfortunately, it must be taken in context: By the time a woman reduces her risk of ovarian cancer by 50%, those same Pills will have caused a 420% increased risk of triple-negative breast cancer.

[Note: readers with delicate sensibilities should skip this next section]

HOLY FUCK. WHAT THE FUCK IS WRONG WITH YOU GUYS?!?!?! I HAVE NOW SHOWN YOU NO LESS THAN FOUR TIMES THAT THIS IS A BLATANT LIE. GET YOUR FUCKING FACT STRAIGHT.

[Those with delicate sensibilities can now come back]

Ahem. 1Flesh, please direct your attention to this:

This (outdated) study examined the risk association between oral contraceptive usage and triple-negative breast cancer (again, the rarest form of breast cancer) among women who were diagnosed between the ages of 20 and 45 between the years of 1983 and 1992. The actual results of this study are as follows:

Women in this cohort who used OCs for more than one year had a 2.5 fold increase in the risk of triple-negative breast cancer, with the risk of triple-negative breast cancer being higher for women under 40 years of age (a 4.2 odds ratio). However, there was NO significantly increased risk with OC use for non-triple-negative breast cancer among any women, nor for triple-negative breast cancer among women 41-45 years of age.

There we go. That’s better, right? Accuracy in reporting always helps.

Further, it should be noted that the study did not differentiate between various types of hormonal contraception, though it is likely that many of the women in the study (particularly those who had been taking the pill for longer periods of time, and who were more likely to suffer an increased risk) had been taking oral contraceptives containing much higher doses of hormones.

To explain, OC’s available to women in this study would have most likely been first generation or second generation.

And, as explained here, lower levels of hormones (particularly newer formulations of hormones) = lower levels of risk. And, actually, we have some data to back up that assertion:

The largest modern study, published in 2002, enrolled more than 4500 patients with breast cancer and 4500 controls aged 35 to 64 years from the United States from 1994 to 1998. Key findings from this study included no breast cancer risk among current (OR, 1.0; 95% CI, .8 – 1.3) or former (OR, 0.9; 95% CI, .8 – 1.0) OC users and no risks associated with duration of use or dose of estrogen. Moreover, a recent study of OC use in more than 4200 patients with breast cancer found no association between breast cancer mortality and OC use when duration of OC use, time since first use, age at first use, and use of specific formulations was examined. While breast cancer risks of the newest formulations of OCs are still unknown, based on the most recent data, they are predicted to show no association with the newest dosages and compositions of the estrogens and progestins being used.

and a 100% increased risk of cervical cancer.

Source, please?

Oh, wait. I’ll do it for you. An article published in the Lancet in 2007 found that, among women currently using OCs, the risk for invasive cervical cancer increased with increasing duration. For instance, women who had been using OCs for 5 or more years had approximately twice the risk versus women who had never used them (relative risk). BUT when the researchers applied this relative risk to the absolute risk, they found that using oral contraceptives for ten years (e.g. from age 20 to 30) raised the cumulative incidence of invasive cervical cancer from 3.8 to 4.5 per 1000 women in industrialized countries, and from 7.3 to 8.3 per 1000 for women in developing countries.  Further, that whole, “correlation does not equal causation” thing is particularly important here as oral contraceptive users may have more unprotected sexual encounters and an increased exposure to the human papillomavirus, a known risk factor for cervical cancer.

Further, the study authors noted that the slightly increased risk of cervical cancer needed to be weighed against the roughly 50% reduction in the risks of ovarian and endometrial cancers. One model actually estimates that for every 100,000 women, 44 fewer reproductive cancers would occur amongst users than in nonusers.

Women should not be demeaned into the position of “choosing their cancer.”

“Choosing their cancer?” Weighing the potential costs and benefits of any medication is what smart, educated people do. And, as I’ve discussed in this and other posts, the ONLY cancer for which current oral contraceptives have been correlated to even a SLIGHTLY elevated risk is cervical cancer, and that has to be weighed against the fact that oral contraceptives can PREVENT many other cancers, and many other diseases.

In terms of cancer prevention, oral contraceptives have been found to have significant positive effects in preventing endometrial cancer. For instance, studies have found the risk of endometrial cancer to be 30 to 50% less among OC users than non-users.

Oh, and lest we forget about colorectal cancer, note that a meta-analysis of 11 controlled studies and 7 cohort studies found a RR of .81 (CI 95%, .72-.92) in OC users compared to never users, with the reduction in risk being greatest among recent users.

Finally, as 1Flesh seems so keen on lying to the public about the risk of breast cancer related to oral contraceptives, it might be  good to mention that current users of OC’s have at least a modest reduction in the risk of benign breast disease (which can potentially progress to cancer).

Further, there are some other awesome GOOD things that OCs can do FOR you. We’ve already talked about the cancer preventative properties of oral contraceptives, but there are also benefits in terms of decrease in symptoms or a decreased risk of several conditions, such as dysmenorrhea, anemia, acne, hirsutism, ectopic pregnancy, ovarian cysts, and pelvic inflammatory disease (research shows a 10 – 70% reduction in PID).

Oral contraceptives can also help prevent osteopenia and osteoporosis, a subject near and dear to my heart (I was diagnosed with osteopenia at age 24 due to low estrogen levels). Studies have shown that because oral contraceptives provide a consistent dose of estrogen, they may increase bone mineral density by promoting higher peak bone mass. This benefit has been reported even with ultra-low-dose formulations, and the positive effect increases with higher doses and longer use.

Finally, OC’s that contain third-generation progestins improve dyslipidemia by improving serum lipoprotein profiles by increasing HDL and decreasing LDL.

So, really, when considering whether or not to use an oral contraceptive, women should be weighing the slightly elevated relative risk of cervical cancer (which, again, has never been causally proven) with ALL OF THE BENEFITS LISTED ABOVE, including a reduction in other types of cancers.

Photo courtesy of Medieval Karl

Photo courtesy of Medieval Karl

I think I deserve one of these for all this knowledge I’m throwin’ down.

Treating the risk of cancer with a known carcinogen is silly, especially when there exists an entirely natural, non-carcinogenic method of reducing ovarian cancer risk:

Hmmm…not to be mean, but a lot of the drugs to treat various health conditions, including cancer, are carcinogenic. But whatevs. Moving on.

According to the review Epidemiological and Genetic Factors Associated With Ovarian Cancer, giving birth to just one child results in a 40% decreased risk of ovarian cancer, with a further 14% risk reduction for every birth afterwards, and a further decreased risk if a woman chooses to breastfeed. What would take approximately 10 years for a carcinogenic pill to achieve can be achieved naturally in 9 months.

O.M.G. You did NOT just tell women that, in order to avoid ovarian cancer, they should just have kids. Wait, you did. W.T.F. Are you insane. The ENTIRE REASON your page exists is to help people AVOID pregnancy. Why the hell would you be telling people to get pregnant to avoid a certain type of cancer?

What about women who choose to be childless? What about women who can’t have biological children? What about women who never get married (I mean, I’m cool with unmarried people getting pregnant and having kids, but something tells me 1Flesh isn’t)? What about people who choose to adopt? What about women who simply aren’t ready, right now, to have a child?

Also, it’s not as if pregnancy and childbirth are without risks. Did you know that the US currently ranks 50th (FIFTIETH) in the world in terms of maternal mortality (that’s women dying from causes related to pregnancy and childbirth). Hundreds of women die every year in the US from pregnancy and childbirth-related causes, and tens of thousands more NEARLY die. And that doesn’t include all the women who suffer lifelong debilitating medical problems as a result of their pregnancies and/or childbirths.

None of what I said above is to say that women SHOULDN’T have children. But to blithely say that, “oh, you don’t want ovarian cancer? Just go have a kid and breastfeed it,” without any concern to the right of women to determine the number and spacing of their pregnancies, and to the complications of pregnancy and childbirth is just…well…wrong.

Obviously, bringing new life into the world cannot be seen as mere medicine, but the message from our bodies is clear: Fertility need not be feared and destroyed, but can be embraced as a benefit.

And, again, we go back to Creighton. Shady, shady method, with shady, shady measurement. Check the bottom of this post to learn more.

Till next time,

– H

© Heather Parker and Antigone Awakens, 2012-2013.

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