birth control pill and hormone replacement therapy increase risk of depression, osteoporosis and breast cancer

Already reeling from all the negative research, three just published studies have hormones on the ropes. The first two concern women in the first half of their lives; the third concerns women in the second half.

Teenage Girls, Birth Control & Depression
Depression is disturbingly common, but, it is twice as common in women once they hit the teenage years. Recent research is beginning to suggest that the hormones estrogen, progestogen and testosterone may contribute to the different odds faced by men and women. That means that oral contraceptives could play a contributing role in female depression. Several studies suggest that they do. A huge Danish study found that, in the short term, hormonal contraceptives are associated with increased use of antidepressants and higher risk of depression. The link was particularly strong for adolescents.

So, researchers in Canada conducted a well-controlled study to see if using oral contraceptives in adolescence is associated with long term depression in adulthood.

The study included 1,236 women and compared those who first used oral contraceptives in adolescence with those who first used them as adults or who never used them at all. Compared to women who first used oral contraceptives in adolescence, women who never used them were 69% less likely to suffer depression as an adult. Though the impact was less than women who began taking the birth control pill as teenagers, women who started using oral contraceptives as adults were also more likely to suffer from depression.

This study suggests that oral contraceptives are linked to depression and especially shows that early use of oral contraceptives as a teenager is linked to depression later in life.

Teenage Girls, Birth Control & Bone Density
A new Canadian meta-analysis looked at nine studies of women between the ages of 12 and 19 who were on combined estrogen and progesterone birth control pills and compared them to women who were not. The studies followed 1,535 women for one year and 885 women for two years.

What the researchers found is very concerning. The one year study found significantly lower bone mineral density in the birth control group; the two year study found highly significantly lower bone mineral density. That means that taking birth control pills as a teenager could increase your risk of collapsed vertebrae and fractures as an adult.

The researchers called these results a “concern” that “suggests a potential public health problem.”

Menopausal Women, Hormone Replacement Therapy & Breast Cancer
Already almost a quarter of a century ago, a meta-analysis of evidence from around the world had demonstrated that women who recently or who currently were using hormone replacement therapy were at increased risk of breast cancer. In the years that followed, much new data has become available. And the news has only gotten worse.

A meta-analysis of all the evidence found that every single form of hormone replacement therapy, with the sole exception of vaginal estrogen, was associated with an increased risk of breast cancer. And the risk increased as the time on hormones increased.

For women who are current users of hormones, during the first four years, the risk of breast cancer went up by 60% when the therapy was an estrogen-progestagen combination and by 17% for estrogen alone. By the years 5-14, breast cancer risk had gone up by 108% for combination users and by 33% for users of estrogen alone: that is the risk doubled as the time increased. When estrogen-progestagen was taken daily, instead of less frequent doses of progestagen, the risk went up by an even more alarming 130%. During years 5-14, the risk was greater for estrogen-receptor-positive tumours. The risk was the same for women who started taking the hormones any time between the ages of 40 and 59. The risk may be lower for women who started after 60.

At least some excess risk of breast cancer persists for more than 10 years after quitting for women who have taken the hormones for a year or more. The longer the hormones were taken, the greater the residual risk.

These “highly significant” percentages mean that for women who go on estrogen-progestagen hormone replacement therapy at the age of 50 and who stay on it for 5 years, there would be an increase of breast cancer of about one woman in every 50. The increase would be one in every 70 for women who take estrogen plus intermittent progestogen; and one in 200 for women who use estrogen alone. Ten years of use would double the risk.

This study means that women who start taking hormone replacement therapy around the time of menopause increase their risk of invasive breast cancer. The increased risk revealed by this massive study, according to Gillian Reeves, one of the co-authors of the study, is higher than previously thought.

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