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Forum Name: Gynecology

Question: Long term oral contraceptive use, side effects?


 Bowenc11 - Fri Dec 11, 2009 4:38 pm

I have been on oral contraceptives since I was 15 (I am now 25 and have used various pills over the years {currently Necon 1 35}), as I do not intend to have children anytime soon, I imagine I will utilize some sort of contraceptive for several more years. For the last 2 1/2 years I have abnormal paps and subsequent colposcopies (approx 5 now, no HPV). My Mother and her side of the family has a history of HTN, heart disease and breast CA (Father and paternal familys medical hx are unk).

My question is, should I consider switching to an IUD? Some studies say long term bc pill use can increase risk of breast and cervical CA, some say they don't. I don't want to continue taking something that can cause me to be worse off than just pregnant and with my family's medical hx, cervical and breast CA are both of concern to me.
 Debbie Miller, RN - Sat Dec 19, 2009 11:30 am

User avatar Hello,
I can understand your concern. Family health history is an important factor in determine risks and benefits. For long-term use, I would recommend that you consider an IUD since it is very effective, reversible and you don't have to worry about it once it is in place. The cost would be a consideration if you were only wanting it for a few months. But, like with all methods, it is not perfect and there are side effects. There are two types - one which also uses a low dose hormone, similar to the pill (such as Mirena) and one which does not (such as Paragard T). If hormones are your concern, you should choose the latter variety if you decide to go this route.

You should research this and discuss the options with your provider. Some women report heavier periods with these - not as much with the Mirena due to the hormones. There is a slight risk of infection, perforation and long-term effects on future fertility (resulting from these potential, though rare complications). The Mirena does carry similar risks to oral contraceptives due to the hormones.

We do not know all possible disadvantages to long-term pill use but hormones do bring some risks. The modern oral contraceptives do not have the high rate of estrogen that were in the early pills so they are considered safer but for some women, they still pose a risk - especially in smokers over the age of 35. They do bring a slightly higher risk of breast cancer, according to a 1996 study. A 2003 analysis by the International Agency for Research on Cancer (IARC) found an increased risk of cervical cancer with longer use of OCs. They may actually reduce slightly the risk of endometrial and ovarian cancer. Of course other factors also play a roll in your overall risks.

As with all health matters, you and your provider need to discuss this thoroughly so you make an informed decision.

Best wishes.

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