Side effects
Does the pill cause cancer?
Quick answer
Not simply, no. The combined pill slightly raises the risk of breast and cervical cancer while you take it, and that extra risk falls back over about 10 years after stopping. It also lowers the risk of womb, ovarian and bowel cancer.[src]
Both sides of the ledger
"Nakaka-cancer ba ang pills?" usually gets a one-word answer from a relative or a Facebook post. The honest answer has two columns. The NHS summarises the evidence on the combined pill like this:[src]
| Cancer | Effect of the combined pill |
|---|---|
| Breast | Small increase in risk while taking it, falling back over about 10 years after stopping |
| Cervical | Small increase in risk while taking it, falling back over about 10 years after stopping |
| Womb (endometrial) | Lower risk |
| Ovarian | Lower risk |
| Bowel | Lower risk |
This applies to combined pills such as Trust (levonorgestrel + ethinylestradiol), Lady (levonorgestrel + ethinylestradiol) and Yaz (drospirenone + ethinylestradiol). The protection against ovarian and womb cancer is one of the less talked-about benefits of the pill. [TODO: source: how long the protective effect on ovarian and womb cancer lasts after stopping (Cancer Research UK or IARC)]
What "slightly" means
Breast cancer is uncommon in women in their 20s and early 30s, which is when most people use the pill. A small increase on a small starting risk is still a small number of extra cases. The risk is also not permanent: it fades once you stop.[src] That is why doctors do not tell healthy young women to avoid the pill because of cancer, but do ask about breast lumps and your personal history before prescribing.
If you already have or have had breast cancer, hormonal methods are generally not for you. WHO rates current breast cancer as a reason not to use combined pills, and copper IUDs are the usual alternative.[src]
Cervical cancer and screening
Almost all cervical cancer is caused by long-term infection with HPV, a virus spread through sex. The pill does not cause the infection. The small rise in risk seen in pill users may be partly linked to having sex without condoms. [TODO: source: WHO cervical cancer fact sheet on HPV as the cause]
What protects you most is screening. Ask your barangay health center, RHU or OB-GYN about a Pap smear, VIA or HPV test, and about the HPV vaccine. [TODO: source: DOH cervical cancer screening program (VIA, Pap, HPV vaccine availability)] Starting the pill is a good moment to book one.
If cancer runs in your family
- Tell the doctor who prescribes your pill about any close relative with breast or ovarian cancer, and at what age.
- A strong family history of ovarian cancer can make the pill's protective effect more relevant, not less. Your doctor will weigh this with you.
- If a known gene change (such as BRCA) runs in the family, ask for specialist advice before choosing a method.
Long-term use questions are covered in is it safe to take the pill for years.
Frequently asked questions
Nakaka-cancer ba ang pills?
Bahagyang tumataas ang risk ng breast at cervical cancer habang umiinom, at bumabalik ito sa normal sa loob ng mga 10 taon pagkatapos huminto. Pero bumababa naman ang risk ng cancer sa matres, obaryo at bituka.
Do progestin-only pills like Daphne cause cancer?
The NHS figures above are for the combined pill. Women with current breast cancer are generally advised against all hormonal methods. Ask your doctor about your own risk.
Should I stop the pill if I find a breast lump?
See a doctor promptly to have the lump checked. Do not stop without a plan, because stopping can leave you unprotected. Use condoms if you do stop.
This guide is for information. Talk to a doctor before starting, stopping or switching birth control.
Sources
- Combined pill: risks and side effects, NHS
- Medical eligibility criteria for contraceptive use, World Health Organization