In general any type of hormonal anything is probably dangerous. Endocrine system is incredibly complex and connected in many different, mostly unknown ways.
And contraceptives play with hormones that are central to what makes women women.
These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation.
I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.
A large part of the risk can be mitigated by the fact that trans HRT uses bioidentical hormones and that you change the delivery route to transdermal or injections. The risk was substantial 30-40 years ago when trans HRT also used syntehtic hormones, but seemed to have leveled out to near nothing now.
Varying levels (big spikes, big valleys) are an issue too, but very few people are interested in doing anything about it. I'd love to be offered polyestradiol phosphate for instance. But such drugs are very rarely offered to anyone trans, because even after years of HRT, I could suddenly want to detransition and then this lasts too long. Or something.
It’s already suspected though not proven (as far as I know) that estradiol increases breast cancer risk, but I imagine most of that is because it encourages significant breast tissue growth.
HRT as applied to gender dysphoria in transgender women absolutely causes breast tissue growth. That is one of the desired effects. Seeing as 99% of breast cancers occur in women, and HRT causes the patient to have very female like breasts, it would be surprising if the patient did not see an increased risk of breast cancer compared to not taking HRT.
Weather or not their risk is higher than the baseline risk for women is less obvious.
> In general any type of hormonal anything is probably dangerous. Endocrine system is incredibly complex and connected in many different, mostly unknown ways.
By that logic sugar should be a controlled substance and we should all be gonadectimized. Gonadectimized animals almost always live longer.
> And contraceptives play with hormones that are central to what makes women women.
Weirdly estrogen in utero is central to what makes male mice male mice, and adult men adult men (20–55 pg/mL estradiol in adult men or about 1/10th the level of adult women). Estradiol plays many important roles in the body of all human adults.
> These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation.
> I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.
Maybe, maybe not, since chronic use of any medication will result in chronic side effects and physical interventions such as copper IUDs are also associated with a host of serious side effects. The best course of action would be to develop interventions that are safe in animal models, give them to humans for a while, and monitor the outcomes, which is what is going on here.
I'm surprised that the outcomes observed aren't worse, given how strongly carcinogenic estrogens are on a dose-dependent basis in animal models. Hormones are strange. Women with many children have reduced amounts of breast cancer despite being exposed to absolutely enormous levels of estrogens and progesterone during and after pregnancy.
Statistically significant, but slight (~25% increased risk, on average.) Still not great.
Obviously, copper IUDs are an alternative for many, though they have their downsides. One of the big uses of hormonal contraception is managing heavy periods, PMDD and other medical conditions. I had a friend who would throw up for days every time she was on her period. It went away pretty completely on birth control.
The magnitude of risk increase in percentage has to be understood in context of baseline probability.
25% additional chance of getting hit by lightning and 25% additional chance of getting heart disease are two completely different results -- I don't mind the first but I would be scared by the second.
About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer.
> About 13% of women develop breast cancer during their lifetime. 25% increase is then very significant, this is about additional 4% chance of getting cancer.
The study didn’t measure lifetime risk, so your assertion is not correct. It measured risk of acquiring breast cancer before age 49. This is not the age when most women get breast cancer. Average age of onset for breast cancer in the US is 62.
While you are partly correct, the study just "didn't measure". It means the study does not say anything about getting cancer after 49. What it does not say is that there isn't any increase after the age women typically stop using contraceptives.
In particular, since we don't know the mechanism in which contraceptives cause cancer, we can't say whether trend ends when women stop taking them or will increase their chance of getting cancer for the rest of their lives.
Every single girlfriend I had, I asked her to get off contraceptives because of the medical dangers and I didn't want to be responsible for any problems associated with it. Instead I took responsibility for making sure she wouldn't get pregnant. One of my girlfriends actually got mad at me because I was *too* careful about getting her pregnant, and interpreted that as me not wanting to get married to her (which since we're not together ended up being true I guess).
This doesn't work for everyone but I'm fairly responsible, and no accidental pregnancies, so it worked for everyone I was with. The same way went for my wife as well, and we have 2 kids now, with no accidentals ones. I'm going to teach my son this as well, that the responsibility is on both parties but as the man you need to control what you can control and don't leave things to chance, especially something as life changing/destroying as an accidental pregnancy.
Wow. I'd probably break up with a guy who "asked me to get off contraceptives". If you want to be responsible about preventing pregnancy, that's fantastic. If you feel like that's any more than an input to her decision of whether to be on it, that's a pretty fundamental overreach.
Maybe I'm being overly generous, it seems like it may be possible for this kind of thing to be more of a request out of support/concern for a loved one's health, rather than one of control or knowing better than a woman. It has been my understanding that many men don't consider such things.
My lady has had horrendous experiences with hormonal contraceptives. Based on what we know of it, if she ever expressed wanting to try it again, I'd ask she reconsiders, or that we explore other options. She would appreciate that as being thoughtful (not as me claiming to know what's better for her, better than herself.)
For everyone the circumstances and relationship dynamics are different.
And it's kind of disheartening to read a well-intentioned comment, see people assuming their own completely different context and then getting slightly aggressive about it.
It's only disheartening to me because woman live in a society where men perpetually behave like we know what's best for them.
What you're reading as aggression, I'm reading as a reasonable response to a perfectly plausible alternative interpretation, which is that he knows what's best for his girlfriends better than they do for themselves.
So many men have this corrupt mode of thinking that there is now an entire US state issuing bounties on women seeking control over their own bodies.
> woman live in a society where men perpetually behave like we know what's best for them.
Everyone lives in a society where everyone else behaves like they know what's best for them. Men currently happen to have more power to enact their plans, but it's about power, not about gender, and all people who seek power think that they know best.
> a perfectly plausible alternative interpretation, which is that he knows what's best for his girlfriends better than they do for themselves.
We are literally commenting on the article confirming using hormonal contraceptives increases the risk of cancer. So if your partner is using these you basically have two options: 1) ignore the issue and maybe not even mention it to her as this could be misinterpreted as influencing her decision, 2) address it out of pure concern for her future, even years ahead when you're no longer together.
3) bring it up to make sure she is aware of this possibly new information, and assume she will use it to inform her decision making? What do you think I meant by providing input to her decision? What on earth made you pull out the straw man that you can’t even influence them?
Go to any relationship subreddit and you'll see countless comments where the slightest misstep is treated as some indellible sin. It's terrifying how quickly these people would forsake a loved one. So many unbelievably jaded and cynical people influencing the thoughts of others.
Discussing changes to birth control decisions in the context of a long term partnership is not, in my opinion, the same as having a policy of telling every woman you date to stop using contraceptives.
Meh. It's not particularly controversial so you're being overly dramatic.
I didn't force anyone, we had an adult conversation about it and all my gfs were on the same page. If any one of my gfs wanted to stay on contraceptives in the first place, then great, I would still do the exact same thing to avoid getting her pregnant in case she missed a day, etc. My wife wasn't on contraceptives in the first place so it was basically a non-conversation.
I think having an adult conversation is basic expectations for any healthy relationship. If you interpret broaching a subject as being cause for breaking up with someone... well, that's your prerogative.
Asking someone to change their medication because of the longterm health implications is not just broaching a subject. It is saying that you both have the same information and you believe they have come to the wrong decision - or, more likely, you believe you have better information on the topic and she should be guided by your wisdom. If you can’t tell the difference between that and “broaching a topic”, well, that’s not terribly unusual. If what you think you actually did was “tell all my girlfriends that I will be a completely reliable partner in behavioral contraception so that she would be safe from pregnancy without hormonal birth control, and then go away secure in the knowledge that she could make this decision based on her own evaluation of the risks and benefits of being on hormonal birth control, which are for many women far more extensive than preventing pregnancy”, well, that would be much higher communication skills and awareness on the topic than you’ve demonstrated here.
(Emphasis on the “because of their long term health” reasoning, because asking them to change because of exterior impacts can make sense)
Communication is a two way road. When you're talking about a sensitive topic and people don't know the context of you who are, don't be surprised when you are interpreted in a negative light.
Based on your schoolyard dismissiveness here, it looks like they're spot on and you don't actually care much for adult conversations. You can dismiss that all you want but when people view us negatively in situations like this, it only hurts ourselves, so it's usually our responsibility to communicate better
I don't feel the need to expend energy on anyone who immediately takes an overly negative opinion on a fairly benign sentence. We both know that nothing I say will change anyone's opinion, so why pretend that I should defend myself?
I thought the overly negative response unreasonable, and I have enough experience on the Internet to know that nothing I write will change their opinion, so I don't want to extend the conversation.
I don't feel any particular need to defend my "Internet honor" and if anyone wants to interpret my post as some Handmaid's Tale order for women to submit to my demands, well that's their prerogative.
Why does it upset you that GP would be concerned for his GF's health? I also ask my GF's not to take oral contraceptives because of guilt that they're doing damage to their body for me. None have ever responded negatively, and at the end of the day it was a request. All agreed they did not feel great when taking the pills, but continued because of pressure by society/previous partners.
Because it’s likely that you and GP do not understand the risks as well as you think you do. You are likely not a MD, and even if you were, you wouldn’t be the expert on your partner’s body, they are. The lack of humility is the issue.
Now if your partner brings the topic up to you and mentions health issues they’re experiencing then sure, it’s fine to offer your view, but that’s not how it sounds to us reading.
Why are you assuming that these things didn't come up though? In a committed relationship, I'd be really surprised if your partner didn't share their perspective during this conversation.
Also, people don't need perfect information to have good intentions that can help. My friend might point out that I should cut back on my swordfish intake because it's high in mercury. They don't know my body as well as I do, and they're not an MD, but this seems like a totally fine topic to bring up.
You're suggesting that I never bring up something regarding my partner unless they mention it first. What an absurdly unrealistic and sterile view of love you have.
I see your point but I think the parent didn't mean "ask" as in "told", it's obvious (at least to me!) that such decisions are taken by the woman only. I interpret this as, "I take the full responsibility for not making you pregnant. You can relax now and you don't need to increase the risk of getting cancer out of fear of pregnancy."
I wonder if it's not also the comment format, that is not a full retranscription of the discussion they had, that brings this "ask" to an autoritative verb. The discussion may very well have been "I asked her if she wanted to get off the pill", and the parent took a shortcut on writing.
I did this, and I'm now vasectomized, but even without this operation, the deal was always "I think this may be harmful to you, I would suggest to stop taking it, but that's your move. If you're taking it for contraceptive reasons, we can figure out something else". But this makes for a way longer comment, when you are replying quickly to a topic to provide an opinion on a subject.
In places like the US where women’s reproductive rights are highly contested, many women don’t take well to men making unsolicited requests about their birth control decisions. Perhaps this isn’t the case everywhere, but this site has a very US-heavy readership so it seems reasonable to have that context be the default.
The person who started this thread was having a conversation with his girlfriend as part of a committed relationship, which seems way more important context than what you think is "contested in the US"
“Every single girlfriend I had, I asked her to get off contraceptives” is the tone of someone who is not interested in conversation and wants control. Bottom line.
When your boss asks you to take a ticket, when a parent asks their son to clean their room, when a cop asks a citizen to identify themselves, you don't think those situations imply control? When a romantic partner asks you to change the drugs you are taking, don't you think there is some implication that their satisfaction with the relationship is contingent on it? Maybe we are getting too into the semantics here but I think it's pretty overbearing to make such a request and position it as anything more than a suggestion.
When a cop "asks," the citizen doesn't get to tell her to fuck off. The control is implied by the role not by the word "ask."
This dude's girlfriends are free to tell him to fuck off (as one did) so there's no actual control.
There's a difference between "control" and "being on the same page about big deal stuff." I don't think my wife would marry me if I was a heavy drug user for example. That's not her controlling my life, it's her having a standard for herself. If we are not on the same page we just don't get married.
Presumably this dude doesn't want to date/marry someone who takes on heavy health risk when other options are available, especially when the nature of his can impact fertility and children. That's a very reasonable stance for him to take in his own life.
A romantic partner should not, but some people believe that they deserve authority over their romantic partners. It would be nice to believe that all relationships are handled healthily, but this is something a surprisingly large number of people struggle with, partly because it's not something that you can take a formal training course on.
Maybe I live in a bubble, but the disagreement tends to be between different regions, not between individuals within a region. So unless the woman is a transplant from a pro reproductive rights region to an anti reproductive rights region, I don’t think the sort of interpersonal conflict you have in mind is likely to occur, where the man is vehemently anti reproductive rights and the woman vehemently pro. At least I believe it happens infrequently enough to not assume it as a default.
It very much depends on context where request end and coersion starts. I'd be uncomfortable handing control over contraception use over to someone I've known for not so long. Just like a lot of guys use condoms because they don't trust the word of a women when she's saying she's on contraceptives.
Only in societies that are culturally inclined to open and direct communication. In societies where indirect communication is the dominant form, a "request" might be a command, a polite suggestion or an expression of disapproval, or anything in between.
In relationships, all "asks" are a smidge more than "just an input" that have to be negotiated with diplomacy or you'll probably end up alone a lot
From medicines, to exercise, vaccines, going to GP, having more serious procedures, going to bed on time... contraceptives, condoms, vasectomy, pregnancy... tattoos, piercings... paying bills, mortgage, savings, joint/split accounts... partners will give inputs on everything. There is no overreach. Strange would be if they didn't worry about each other and the family future
You will always have the last say about yourself, but you will also be mad when your partner ignores something you think you're righter
Especially if you end up having children together and cannot handle disagreements on what best for their health and life in general
To be clear: you would never be in any way responsible for problems associated with your partner taking hormonal birth control because it is a choice they make themselves for their own body.
> Instead I took responsibility for making sure she wouldn't get pregnant
You have to understand what a big statement that is. If she does get pregnant there’s only one person guaranteed to have to deal with the consequences of that, and that’s her. Being hesitant to transfer the responsibility to you is very rational, being mad at you over the topic is understandable.
I know your intention is good throughout here but there’s an implication that you know what’s better for their bodies than they do. A better approach (IMO) is to inform them of the risks (which you’re right they may not know) and let them make their own choice.
The “context of a relationship” part is when a couple decide to cease birth control in order to have a child together. The OP is talking about still using birth control, just different birth control that he would prefer she use over the alternatives. Ultimately that should be her choice because the end result to him (no pregnancy) is the same.
>Women take birth control for a number of reasons unrelated to pregnancy
Yes, but don't forget about the elephant in the room: There are a lot of women on birth control who wouldn't be if they weren't trying to avoid pregnancy.
>Ultimately that should be her choice.
Were you under the impression that he was physically preventing his girlfriends from taking birth control?
No, because even if she chooses to terminate the pregnancy and not tell the other party a thing, she is still guaranteed to have to deal with the consequences of that decision. Or if she miscarries before she even knows she is pregnant, she has to deal with that, it’s not a pleasant experience for anyone. Etc.
You are getting weird hate here. You identified a health risk someone you cared about / loved was taking and strongly encourage them to avoid it (and offered other solutions)
This is exactly what a proper partner does. Obviously you didn't force anyone to do it, but being passionate about such a topic is totally valid.
Your story reminds me of mine though - encouraged female friends to avoid the pretty obvious health risk. And also have two kids now and never before :)
Yeah--there's a factor here that messes up the data. Namely, that pregnancy to term is associated with a *reduction* in breast cancer, the earlier the pregnancy the bigger the effect.
This is the reason behind the "pro-life" claim that abortion causes breast cancer--no, it simply doesn't provide the protection. Never-pregnant vs had-abortion is the same risk. Hormonal contraception is more effective and will reduce the oops rate and thus would be expected to show a positive correlation with breast cancer.
(And the oops rate is also why for a young non-smoker the risk of the pill is *negative* even if the response to an oops is an immediate abortion. Carrying it to term increases the effect by at least an order of magnitude.)
> These calculations were then adjusted to take into account established risk factors such as body mass index (BMI), number of recorded births, and the time since a woman’s last birth.
> The researchers also note that although these findings provide evidence about the short-term associations between hormonal contraceptives and breast cancer risk, they do not provide information regarding longer-term associations, or the impact of total duration of contraceptive use on breast cancer risk, since information on a woman’s prescription record prior to joining a participating GP practice would not have been available within the CPRD database.
Hopefully soon, doctors that prescribe birth control for things unrelated to birth control will now stop doing that as that's a reasonably bad thing to do (IMHO IANAD)
I mean, this isn’t new information for doctors. It’s a pretty well known fact that estrogen agonists can increase risks for breast cancer - that’s why decisions made about birth control are patient centric and consider the patients risk factors.
For reference, risks of breast and cervical cancers are increased in women who use oral contraceptives, whereas the risks of endometrial, ovarian, and colorectal cancers are actually reduced.
Birth control is sometimes prescribed to help with heavy period flow, which could be a symptom of a much worst issue (endometriosis). But birth control is also prescribed to help control acne, which in my humble, unprofessional opinion is not a good use, and the risks far outweigh the benefit. Weight loss is another reason it's prescribed. These sorts of off-label perscription for a hormone are not... great IMHO.
Are there other solutions to acne, and weight loss? Yes. Endometriosis is far more complicated.
>Seems like sidestepping the issue to say there are other acne remedies.
My opinion is that estrogen hormone therapy is not the best course of action for acne and is prescribed far too much.
I literally do not know what your beef is with my opinion, since you do not state yours, you just write in weird, obtuse statements, which is common on hn in, I would assume, an attempt to look smart on a subject, in which you are not. See also: contrarianism.
Why didn't you say that instead of "things unrelated to birth control"? It seems like you are walking back from your original position and sticking to the easiest subset of it to defend. My position is that there are legitimate uses for birth control pills besides contraception and there's not a simple replacement for all of them.
After I had the kids I wanted, I got a vasectomy. It’s a painless and quick and largely reversible procedure with no side effects and offers 100% contraception. If you care about your partner and are “done,” I highly recommend it.
> The early failure rate of vasectomy (presence of motile sperm in the ejaculate at 3–6 months post-vasectomy) is in the range of 0.3–9% and the late failure rate is in the range of 0.04–0.08%.
8 out of 10,000 men is still a very low failure rate, although keep in mind that typically failure rates for contraceptives/sterilization are per annum.
So if you get a vasectomy with a 0.08% failure rate and then have sex for 30 years ... 0.08% * 30 = 2.4%.
Considering that one would have to get the hormonal IUD replaced (painful!!) every 3-8 years [1], while vasectomies only require check-ups two times after the procedure (not painful) after 1-2 months, and at one's discretion afterwards, that's a way better value proposition.
Thanks for sharing your positive experience - it's great to hear that the procedure was painless and quick, and has given you and your partner a reliable form of contraception. More important, having a close person in your life whom you can trust is truly a life jackpot! In the current "epidemic of loneliness," it's more important than ever to have strong personal connections.
I certainly didn’t say anything to preclude that. In fact unless the woman is certain of the man, she should control her own contraception. The consequence of a mistake falls disproportionately on her and, well, men are pretty much all assholes, even the well intentioned ones. My message, though, was for men - not for women. Vasectomies are a man’s choice, and the only one we can make that fully insulates the woman in our life from the consequences of sex. Any other measure a man can take is pretty poor in it’s effectiveness.
Yes. Upshot was usually reversible but with reduced fertility, but even when not IVF works because machinery still works and you can clear some sperm even if not successful. So, yes, I waited until I was “done,” and that’s probably the right way to treat it. But even so you could still have kids even in the worst case with some science assist.
The headline is somewhat deceptive. This study doesn’t assess lifetime risk, just risk before age 49. Since most breast cancers are diagnosed well after age 49, it needs to be assessed in that light.
sterilization isn't my view, it's what it is. permanent birth control could include suicide, it's ambiguous.
the only reason one would avoid what you are terming dysphemisms is if you are advocating that people do more of something and you wish to hide what it is.
Calling abortion (which is only one element of what is meant by “reproductive freedom”) “terminating reproductees with extreme prejudice” is a dysphemism by any reasonable standard.
And contraceptives play with hormones that are central to what makes women women.
These hormones are not just limited to regulating when eggs are released from ovaries, they take part in a lot of other processes. It is absolutely not surprising then that there will be other effects of long term hormonal supplementation.
I think the best course of action would be to work on other, non-hormonal contraceptive alternatives.