Fact Sheet - Contraceptive Pill Side-Effects

1) Breast Cancer

For those women starting the pill before 20yrs old, the risk of dying from breast cancer was 820% higher than for healthy nonusers of the same age.(1) *p61
For women starting pill between 20-25 years, relative risk was 180% higher than healthy non-users (1) *p61
Other researchers cite the risk of breast cancer for young women(<20 yrs old) is 200-480% higher than for non-pill users(2,3,4) *p53,219,223
Therefore the range these studies cite for breast cancer is 200-820%

In one study of 918 Dutch women diagnosed with invasive breast cancer, 85% had used the pill at some time (4a)
Even 3 months use of the pill has been reported to be associated with 100% increase in breast cancer (4b) *p49
For more than ten years use, breast cancer risk increased by 310% (4b) *p49
"women with breast cancer, who at an early age have used OC, have larger breast tumours…and a worst prognosis compared with later (pill users) and never users(5) *p60
Death rate from breast cancer
Australia 20.4/100,000
USA 20.7/100,000
Japan 7.1/100,000

ie a x3 fold reduction in Japan. Australia/USA have a pill history of 30 years with identical breast cancer statistics. Industrialised Japan, has no pill use, reports one third the rate (5a)
(Note: With use of Depo-Provera (DMPA) - "Use for two years or longer before age 25 was associated with a significantly increased risk of breast cancer" (ie 360% increase) (6) *p100

2) Cervical Cancer

Pill use in women <20years old means 280% higher risk of cervical cancer
In women 20-24 years, its 70 % higher
In women 25-29 years its 40% higher (7) *p26, 219
Another study cites increased risk of 250% for cervical cancer amongst pill users (8) *p21
Longer term users(6-12 years) 100-340% increased risk of non-users cervical cancer(9,10) *p24,25
However, one of these studies showed women who used the pill for only 1-6 months had a 190% increase in cervical cancer than non-users (9) *p24
Clinical evidence cites the pill's role in activation of and enhancing HPV (Human Papilloma Virus) in initiation of cervical cancer. (11,12) *p36

3) Deep Vein Thrombosis (DVT)

Risk of DVT increased by 600-900%(ie 5-8 fold) compared to non-users in users of 3rd generation progestagen pills (eg containing gestodene - eg Femodene, Minulet, Tri-minulet, or containing desogestrel - eg Marvelon) (13,14) *p219
Across all age groups, use of the 3rd generation pill brands had a 770% greater DVT risk than non-pill users (15) *p80
Second generation progestagens (levonorgestrel,norethisterone) have 120-280% increase risk of DVT (16,17) *p80,82
For teenagers aged 15-19yrs risk of DVT " for the desogestrel-containing OC was 7-fold higher than that of the levo-norgestrel containing products; among women aged 20-24 the risk was 4-fold higher" (18) *p81 IMPORTANT! Note that this x7 increase was relative to 2nd generation users not non-users!!
Therefore, by computation, risk for 15-19yr olds compared to non-users is
(120%-280%) x 7 = x 15-26 fold risk!!
A x50 fold increase risk of DVT for users carrying a blood clotting factor V Leiden mutation (19) *p81 This occurs in 3-5%of Dutch/Swedish women *p77
Note mechanism - gestodene causes decreased oestrogen metabolism in liver leading to accumulation in body leading to increased DVT risk *p74

4) Infertility after pill-use

Women may not conceive for up to 48 months or longer depending on age (19,20) *p93
This is due to atrophy of the mucus secreting glands thus preventing sperm transport *p94-95
5) Teratogenicity

Birth defects/chromosomal abnormalities in children conceived right after pill cessation (21,22) *p92
COMMENT
Fertility drugs cause hyperstimulation of the ovaries, leading to increased ovarian cancer of the ovary due to increased minor trauma of the covering epilthelium *p141
The pill, and pregnancy, and breast feeding cause a rest in ovulation, thus associated with a decreased incidence of ovarian cancer. Some family planning advocates defend or advocate pill use because of the associated decrease in ovarian cancer rates(0.2% risk). To do so in light of the magnitude of the side-effects of the pill documented is a woeful ignorance of the facts or a deliberate and cynical act of injustice to women.

All references from - A Consumer's Guide to the Pill by John Wilks B Pharm
MPS 2nd Ed1997 ALL Publications
Available from HLI (Ireland) £14 which includes p & p

References

1) Olsson H, Borg A, Ferno M, Moller TR, Ranstam J. Early oral contraceptive use and premenopausal breast cancer - a review of studies performed in South Sweden Cancer Detection and Prevention 1991:15 (4): 265-271 Table IV.
2) Olsson H & ML, Moller TR, Ranstam J, Holm P. Lancet(letter) 1985 March 30, 748-49
3) Olsson H, Moller TR, Ranstam J. Early oral contraceptive use and breast cancer among premenopausal women: Final report from a study in Southern Sweden. Journal of the National Cancer Institute. 1989;81(12):1000-4
4) Johnson JH, Weighing the evidence on the pill and breast cancer Family Planning Perspectives 1989: 21 (2): 89-92
4a) Rookus & Van Leeuwen. Oral Contraceptives and risk of Breast Cancer women aged 20-54 years. Lancet 1994 ; 344; p844-51
4b) Millar DR, Rosenberg L, et al Breast Cancer before age 45 and oral
contraceptive use ; new findings. American J of Epidemiology 1989;129
(2):269- 80,
5) Olsson H, Borg A, ferno M, Moller T, Ranstam J. Early oral contraceptive use and breast cancer in Southern Sweden. Proc. Annu Meet Am Soc Clin Oncol. 1989: A367, Ma
5a) WHO Cancer Mortality database 1994 Breast Cancer Rates by Country.
6) Paul C, Depo medroxyprogesterone (Depo-Provera) and risk of breast cancer Br Med J 1989; 299: p762
7) Thomas DB, Ray RM. Oral contraceptives and invasive adenocarcinomas and adenosquamous carcinomas of the uterine cervix Am J Epid 1996;144:p284 table 2.,
8) Kohler U, Wuttke P. results of a case control study of the current effect of various factors of cervical cancer risk . 2) Contraceptive behaviour and the smoking factor. Zentralblatt fur gynakologie 1994;116 (7): 405- 9 (Ma)
9) Ursin G, Peters RK, Henderson BE, d'Ablaing G, Monroe KR, Pike MC. Oral contraceptive use and adenocarcinoma of cervix. Lancet 1994; 344; 1390-1394
10) Brisson J et al Risk factors for cervical Intraepithelial Neoplasia: differences between low and high-grade lesions American J of Epidemiology 1994;140:700-710
11) Chen Y-H, Huang L-H, Chen T-M. Differential effects of progestins and estrogens on long control regions of human papilloma virus types 16 and 18. Biochemical and Biophysical Research Communications 1996;224:p654
12) Kenney JAW. Risk Factors associated with genital HPV infection. Cancer Nurse 1996 (Oct);19:5, p353
13) Vandebrouke JP, Rosendaal FR. End of the line for "third-generation pill" controversy? Lancet 1997; 349:1113-1114
14) Vandenbrouke JP et al Increased risk of venous thrombosis in oral contraceptive users who are carriers of factor V Leiden mutation. Lancet 1994;344:p 1454
15) Bloemenkamp KW, Rosendal FR, Helmerhorst FM, Bauller HR, Vandenbroche JP. Enhancement by factor V Leiden mutation of deep vein thrombosis associated with oral contraceptives containing third generation progestogen. Lancet 1995;346:8990:1593-6
16) Ref 15 p1594, table 1
17) Spitzer WO, Lewis MA, Heineman LAJ et al. Third generation oral contraceptives and risk of venous thromboembolic disorders: an international case-control study Br Med J 1996;312:83-8
18) Bloemenkamp et al p1595
19) APPG 24th Ed Microgynon 30 monograph 1995 p1508
20) Micromedex vol 89 Oral contraceptives monograph
21) Wade ME, McCarthy PM et al. Am J Obstet Gynaecol 1995; 172: p698
22) Rahwan R, Prof Pharmacology & Toxicology, College of Pharmacy Ohio State University. Chemical Contraceptives, Interceptives and Abortifacients 1995


Patrick McCrystal
Human Life International (Ireland)
Jan 1999

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