Roughly 140 million women worldwide rely on hormonal methods of birth control to prevent pregnancy, ease period cramps, or make endometriosis less painful.
However, the benefits aren’t without risk.
Women who use hormonal contraception, such as birth control pills and intrauterine devices (IUDs), have a slightly increased risk for breast cancer, according to a study published last week in the New England Journal of Medicine.
But the study’s findings aren’t a reason for women to throw out their birth control pills or schedule their IUDs to be removed, according to experts interviewed by Healthline.
That small increased risk translates to one more case of breast cancer for every 7,690 women who take hormonal birth control for one year.
“There’s nothing in life that’s without risk,” said Dr. Jill Rabin, co-chief of the division of ambulatory care and women’s health programs-PCAP Services at Northwell Health in New York.
“The estimated additional risk for premenopausal women is increased [if they take hormonal birth control] — but it is still very low. It’s a portion of a percentage point,” she explained.
Doctors say the questions sparked by this study present an opportunity to pause and think about which birth control method is best for you.
Here are the key things about this study’s findings to keep in mind.
Consider the many long-lasting protections
Similar to making a decision about any medication, it’s critical to look at the advantages, risks, and side effects of hormonal birth control.
The most obvious protection is against unplanned pregnancies, which can involve medications, surgeries, and emotional distress.
These contraceptives may also protect against some cancers that are often discovered in late stages.
The slightly increased risk of breast cancer “has to be weighed against the incredibly important benefits of hormonal contraception. This includes good contraceptive efficacy and the reduced risk of gynecological cancers such as ovarian and endometrial, and possibly colon, cancers,” Rabin pointed out.
After women who take oral contraceptives for five years or more stop taking the pill, their decreased risk for ovarian and endometrial cancers lasts for 10 to 20 years.
In contrast, the heightened risk for breast cancer decreased quickly for women who used hormonal methods for less than five years.
“As soon as the women discontinued it, the risk went back to baseline,” Rabin noted.
Women who used hormonal contraceptives for more than five years faced a slightly increased risk for five years after they stopped, the study found.
For a woman at average risk for breast cancer, the length of the protections against ovarian and endometrial cancers is longer lasting than the risk of breast cancer.
Women have many options, depending on their individual goals, health, and family history.
“The real take home is that [breast cancer risk] is a reason for pause when considering a method for birth control,” Dr. Susan K. Boolbol, Clinical Director of the Mount Sinai Health System Cancer Network and Chief, Division of Breast Surgery, told Healthline.
In terms of benefits and risks, “there is a balance to consider,” Boolbol said. “But that’s why being armed with this knowledge and discussing your options with a physician is of critical importance.”
She recommended that women ask themselves and their OB-GYNs: What are my options? What is the best choice for me?
For every patient she sees, Rabin puts together a contraception menu based on her personal and family health history.
The choices are aligned with the Centers for Disease Control and Protection (CDC) contraceptive criteria, and ranked from least risky to most risky.
The safest option may be different at 20 years old than it is at 40.
Age is a major factor
Fewer than 5 percent of women diagnosed with breast cancer in the United States are younger than 40.
The risk for breast cancer increases as bodies age because cell abnormalities or mutations become more likely.
Women taking hormonal contraceptives in their teens, 20s, and 30s already face a minimal risk of developing breast cancer, so increasing that likelihood still won’t make it a significant risk.
Boolbol suggested that all women reevaluate their contraception methods at 40 years old.
“Breast cancer in your 40s is still not a common disease, but I think at some point women need to stop taking hormonal birth control,” she explained.
Boolbol urged women to start a discussion with their gynecologist when they turn 40. That age is a good time to evaluate risk factors, individual history, and whether it’s time to switch birth control methods.
“The decision is very individual,” she noted.
It’s not a one-time decision
The longer a woman takes hormonal birth control, the higher her risk of breast cancer, according to the study.
Researchers found a slightly increased risk in women who took hormonal contraceptives for more than five years.
There were twice as many cases of breast cancer in women using these types of birth control for more than 10 years compared to women who had only taken hormonal birth control for less than a year.
Still, the overall number of additional cases remained small.
So, should a woman switch up her birth control method every five years?
“We don’t have evidence to say alternating birth control methods is good,” Boolbol said.
Instead, it’s smart to revisit your birth control method with your doctor every 5 or 10 years, depending on your age.
Health goals aren’t the same as standard retirement savings advice to “set it and forget it.”
Women shouldn’t just choose a certain birth control and keep taking it for 10 to 15 years without deciding if it’s still the best option for them.
“Millennials have plans for their career and future, so they need to put at least an equal amount of thought into planning their families, including into larger healthcare goals for themselves,” Rabin said.
“People do have choices, but you have to have a game plan,” she added.
Still, the link between hormonal birth control and breast cancer risk, “highlights that we do need more contraceptives to be developed for women, and especially for men,” Rabin explained.
How to reduce your risk
There are things women can do today that directly impact their breast cancer risk — and they don’t involve burning your pill packets.
“There are many lifestyle choices within our control,” Boolbol stressed.
Take your alcohol consumption down a notch, exercise, and maintain a healthy weight.