The side effects of birth control are wonderfully broad. We’ve come to expect spotting, nausea, migraines, weight gain, and the like, but an increased risk of breast cancer? That’s a bit much. A study in Finland performed over 13 years shows that there is a link between hormonal IUDs and an increased risk of breast cancer. We chatted to specialist surgeon and breast expert Dr Justus Apffelstaedt to unpack what this study means for you and to help set our minds at ease.
A study on the cancer risk of women who use hormonal IUDs
IUDs are a popular choice of contraceptive because of their 99% effective rate and the fact that they protect you from pregnancy for years at a time. This study collected data from over 90 000 Finnish women between the ages of 30 to 49 years old who had received a progestogen-releasing IUD, such as the Mirena. The risk of ductal carcinomas (the most common form of breast cancer which accounts for approximately 80% of all breast cancers), as well as lobular carcinomas (which constitutes approximately 10% of all breast cancers), increased in women with hormone-releasing IUDs. Um, WTF? My gynae never mentioned this.
Okay, I’m kind of freaking out now?
Before you hurriedly book an appointment to rip out your Mirena, Dr Apffelstaedt says relax; there is no such thing as a 100% risk-free contraceptive any way. ‘Any form of medical intervention carries risks and benefits that one needs to consider holistically,’ he says, ‘Does one trade-off of a small increase in breast cancer risk versus the lifestyle benefits these devices offer? This is an informed decision each woman should make for themselves in consultation with their doctor, preferably a gynaecologist.’
The most important points to take away from this study are:
- The breast cancer risk is time-dependent and only increases after 5 years
of using a hormone-releasing IUD.
- If you are above the age of 40, even if you have no significant risk factors
such as cancer in your family, you should go for mammographic
- If you have breast cancer in your family, speak to your gynaecologist
about exploring non-hormonal contraceptive options.
- There is currently no concrete data on whether removing the device will
return the risk profile to normal. While the risk may subside, it will still
remain elevated in comparison with pre-insertion levels.
So how do I decrease my risk of breast cancer?
‘Realistically, if you are changing your internal hormonal environment for an extended period of time (between 10 – 30 years), there are bound to be consequences,’ says Dr Apffelstaedt, who does not recommend the use of a hormone-releasing IUD for more than 5 years. ‘If you wish to extend use for longer than that, it is wise to discuss the risks with your gynaecologist.’
The best way to reduce your risk of developing breast cancer is the classic ‘live a healthy lifestyle’ method:
Eat well and exercise often
Obesity increases your breast cancer risk by a huge 70%. For perspective, this is far higher than the risk associated with having an IUD for over 10 years. Stay active and within a healthy weight range.
Drink less alcohol
Alcoholics are much more likely to develop cancer than non-drinkers. Ease up on the habitual drinking.
Get regular breast checks
Screen your breasts regularly. You can check for lumps by hand and if you’re over 40 you should be seeing your mammographer regularly to be safe.
Only once you have considered all of the above, should you start worrying about the risks your IUD may carry. Dr Apffelstaedt concludes that the study ‘may sound scary, but speaking to your doctor to explore all your options is the best way forward. Every woman is different and birth control is a highly personal decision. The only reason one should consider studies such as this is in order to ensure one is making an informed decision.’
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