Q: I'm in my late 20s and I just broke up with my boyfriend. I don't need contraception, but I've been on the pill for the last three years and I like what it does for my cycle. I am also concerned because my mom had breast cancer in her late 50s. Should I still continue taking birth control pills even if I don’t need contraception?
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A: If there are no contraindications (such as a history of clots, estrogen-related cancers or uncontrolled high blood pressure), sure, go ahead and continue taking your birth control pills.
Just so you know, at least one third of women who use the pill do so for noncontraceptive reasons. There are a lot of benefits associated with this form of contraception that you may want to consider. You've probably already noticed that taking the pill has led to regular and lighter menstrual cycles, decreased cramps, and may even have had a positive effect on some PMS symptoms. (In fact, the FDA has approved a particular pill brand containing a new progestin called drospirenone for the treatment of PMDD — premenstrual dysphoric disorder — which, put succinctly, is really bad PMS.)
The FDA has also stated that there are definite health benefits to taking combined oral contraceptives (COC) pills that contain both estrogen and progestin. This was based on their analysis of epidemiological studies that largely used oral contraceptive formulations containing more than 0.035 mg (or 35 micrograms) of ethinyl estradiol (a type of estrogen). However, recent studies have shown that the benefits related to taking low-dose COCs (those with less than 35 micrograms of ethinyl estradiol) are probably as good as those attained from a high-dose pill.
So what are these benefits? Use of the pill for more than two years can decrease the future risk of ovarian cancer by as much as 70 percent and endometrial cancer by 50 percent. It can also decrease blood loss by 45 percent, decrease cramps by as much as 50 percent, acne, 50 percent, and benign ovarian tumors by 20 percent. Obviously, it can also protect against pregnancy. Finally, higher-dose pills have been shown to decrease the development of ovarian cysts and fibroids (though low-dose pills may not be as effective).
With regard to your concern about breast cancer, studies have shown that women with a family history of breast cancer are not at an increased risk of developing the disease with COC use. Moreover, the CDC (Centers for Disease Control and Prevention) has stated that the current or past use of birth control among 35- to 64-year-old women didn't increase their risk of breast cancer. They even checked women who are known to have a mutation in the genes related to breast and ovarian cancer (called the BRCA1 and BRCA2 genes) and found that a low-dose pill still didn't increase their breast cancer risk. They have found, though, that COC use will decrease the risk of ovarian cancer in these women.
Dr. Reichman’s Bottom Line: If you like the fact that your periods are regular and easier, and you want some of these noncontraceptive health benefits, I don't think you need to take a break from the pill. And remember, when it comes to ovarian cancer, combined oral contraceptives are the only current mode of prevention.
Dr. Judith Reichman, the TODAY show’s medical contributor on women’s health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, “Slow Your Clock Down: The Complete Guide to a Healthy, Younger You,” which is now available in paperback. It is published by William Morrow, a division of HarperCollins.
PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.
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