The results of a study by the Guttmacher Institute were just released. It tells an interesting story about why American teenage girls are choosing birth control pills for noncontraceptive reasons.
The study points out that little data has been gathered previously on the use of oral contraception for purposes beyond that of preventing pregnancy. The federally funded survey done from 2006-2008 titled the "National Survey of Family Growth" examined the reasons why women and teens are using the pill for noncontraceptive reasons.
The Guttmacher Institute estimated from this survey that 1.5 million women in the U.S. are using oral contraception for noncontraceptive purposes. This includes reasons such as acne, primary dysmenorrhea, prevention of migraines, fibroids, excessive pelvic pain, bleeding and other "side effects" of menstruation. The Guttmacher institute says "The reliance on birth control pills for noncontraceptive reasons is highest among pill users who are teenagers. In fact, teens are more likely to report using the pill for noncontraceptive purposes than for birth control: Some 82% of 15-19 year-olds who use OCPs say they do so for non-contraceptive reasons".6 The three most common reasons are: menstrual pain, menstrual regulation and acne. The survey did not ask about other hormonal methods of contraception ie. the ring, patch, implant or IUD. The data was gathered using in-person interviews with 7356 women aged 15-44.
Oral contraception is artificial hormone regulation of the endocrine system and the risks of these drugs can be serious. A friend of mine, healthy at age 30 suffered a stroke from birth control pills and four years later still has no use of her left arm and walks with an extreme limp. She started the "Pill" at age 15 to alleviate her painful periods. I do not want to scare you, so I will refrain from further stories from patients or friends, about the use of birth control pills. But, do the 82% of teenagers using the pill for noncontraception reasons understand the risks of these drugs? Do they know all the possible ramifications of their choices? My friend has said many times,
"I wish I had known, I never would have taken the pill if I knew this could happen."
Dr. Larry Norton is a well known breast cancer doctor at Memorial Sloan Kettering Hospital in New York City and when interviewed on Oprah.com had this to say about birth control pills. "Birth control pills are an estrogen-progesterone combination, so they bring up the same fears as HRT. Some disagree with me, but I just don't see a reason to take the Pill–even for younger women. The fact is, breast cancer cells, at least in the formative stages, like estrogen. So the more continuously you feed them the estrogen, the greater the likelihood you'll have a malignancy. With the sexually transmitted diseases that we have to worry about nowadays, I think barrier methods make a lot more sense." 1
Do our teenagers have this information? Do they know that in 2005 the World Health Organization (WHO) declared that "combined estrogen-progestogen oral contraception is carcinogenic to humans."2
Do these teenagers know about BRCA 1 and BRCA 2 genes? Are teens getting checked to see whether they carry this gene mutation? This mutation gives a woman "a 36-52 percent risk of developing breast cancer by age 70"3. Personally, I would want this information to make my choice about oral contraception an informed one. I want to know about any drug that can possibly cause cancer cell growth, especially if I have a gene that puts me at a higher risk for cancer.
The Breast Cancer Fund has a book called "State of The Evidence"4 (this book is free and online) in which they sum up a number of studies on birth control pills with the following statements: "Numerous studies have shown an increase risk of breast cancer in women using oral contraceptives …. especially those who start taking birth control pills earlier in life and take them for a longer period of time."5
What do you think? Do the teenagers possess this information and are they making informed choices about their health? Is all the information available to them and are the facts presented properly? Drugs have serious ramifications and not all are immediately evident. Teens choosing oral contraception for menstrual cramps and acne is a personal choice that requires some serious study.
Women have more choices today than ever before. Choices have ramifications and choices about our health and drug use are no exception. Freedom of choice is a wonderful thing and I support it 100%. I believe choices should be made after carefully weighing benefits and risks. Due diligence is especially important when the choice could involve serious health consequences.
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References:
1. http://www.oprah.com/omagazine/Breaking-News-on-Breast-Cancer/2#ixzz1dzBMRJKk
2. http://www.iarc.fr/en/media-centre/pr/2005/pr167.html
3. Dr. Susan Love http://blog.dslrf.org/?p=24
4. & 5. Breast Cancer Fund http://www.breastcancerfund.org/assets/pdfs/publications/state-of-the-evidence-2008.pdf
6. Guttmacher Institute study http://www.guttmacher.org/pubs/Beyond-Birth-Control.pdf