What Young Women Should Know

Today I want to just simply point out some clinical references that I feel every young woman should read before making decisions about their health, their family planning needs, and their cancer risk.  This is just simply a regurgitation and focus on some articles that I have been made aware of throughout the years and feel compelled to share.  The focus of these references and various clinical studies is on "The Pill" (oral contraceptives containing oestrogens) and the long term effects that have been noted after this class of pharmaceuticals came to market in the 1940's. Please do some literature review for yourself and read further into the noted studies to make a determination if this is the route that you want to take.  I personally am not an advocate of oral contraceptives (or synthetic menopause therapies) because of these types of studies but also because after doing bio-identical hormone therapy for many years, I just don't think there is anything that compares to using a perfect match to the bodies own production when it comes to hormones.  'nuf said. 

Around the time of "the Pills" initial debut (it really became more popular in the 60's) , an American womans lifetime risk of cancer was 1 in 20.  Now it is 1 in 8.  According to a report in the Nov 1995 Natural Fertility Management newsletter, the pill causes 150 chemical changes in a girls body.  Today we are seeing girls as young as 13 on birth control pills to regulate their menstrual cycles, but in some cases simply to control their acne and complexion.

By the mid 1970's a test allowing doctors to identify oestrogen-dependent tumours established that approximately 1/3 of breast cancers contain cell chains that hook up with oestrogen molecules. This is what we call ER+ (Estrogen Receptor positive) tumours.  Very simply, they grow when exposed to oestrogen and shrink when their supply is removed. The Kaiser Permanente tumour registry in the US revealed that from 1974 to 1985, the incidence of ER+ tumours rose 131 percent. Yikes!

Dr. Max Cutler, a highly respected Los Angeles surgeon gave a testimony in the US Senate Hearing which invesigated "the Pill". His testimony, "I have a series of patients who have had two or three breast biopsies.  In some, the biopsies were performed before the patient started to take the contraceptive pill, and a second or third biopsy was performed after the patient had been on the Pill for several years.  Study of surgical specimen under these circumstances presents a unique opportunity to observe the tissue changes." His biopsies showed "increased cellular activity, reflecting the stimulating effects of oestrogen." He testified that "the risk is a potential time bomb with a fuse at least 15 to 20 years in length." Seventeen years later, Dr. Philip Corfman became the director of the endocrine and metabolism division of the FDA and high-dose oral contraceptives were withdrawn from the market.

Dr. Clair Chilvers released a study in Lancet in 1989.  She found that "there was a highly significant trend in risk of breast cancer with the total duration of oral contraceptives.  Women using the Pill between 49-96 months had a 43 percent greater risk of breast cancer and users of more than 97 months had a 74% greater risk. 

This was backed up by the American Journal of Epidemiology in 1989.  This publication reported that women on the Pill for at least 4-10 years beginning early in life have a 40-70 percent greater risk of premenopausal breast cancer than those who never took the Pill.

Harvard School of Public Health in a review paper published in Cancer revealed a statistically significant positive trend in the risk of premenopausal breast cancer for women exposed to oral contraceptives for longer duration.  The risk was predominant in those who used oral contraceptives for at least 4 years prior to their first term pregnancy.

These studies really point out that the dosing, age at therapy start, and length of time on the Pill are the key determinants in increased breast cancer risk and adverse events.  If one has to use birth control pills under the advice of their physician, my advice is to use them for as short a time as possible. 

This is such a sensitive topic, but again one that I think every woman should seek her own answers to based on symptoms, irregularities, and family risk of cancers.  Access to the internet and other forms of educational tools make the path of enlightenment easier these days.  Use these tools wisely.  I encourage every person to "do their homework" when it comes to making a decision such as this. 

To your good health,
Dr. Sonja