By Matthias Muenzer, MD.
Lawrence Memorial Hospital of Medford, Melrose-Wakefield Hospital
Certain forms of birth control may decrease your risk for ovarian cancer.
For years, women have dealt with a barrage of myths and street knowledge about birth control. One of these commonly held concerns is that certain contraceptives, such as “the pill,” cause ovarian cancer. But research has suggested that the opposite is true.
In fact, since 2014, we have been prescribing two forms of birth control with the goal of preventing ovarian cancer in mind:
- Oral birth control, a.k.a. “the pill”
- Severing or removing part of the fallopian tubes, otherwise known as tubal resection
What’s the risk of developing ovarian cancer?
Ovarian cancer is not common, and it can be very difficult to treat. Studies have failed to identify key risk factors for developing ovarian cancer, but we do know that having a family history of breast cancer or ovarian cancer — specifically those cases related to the BRCA gene mutation, or the breast cancer gene — increases a woman’s risk.
We also know that risk increases with age. The lifetime risk of developing ovarian cancer is one in 72, or 1.4 percent by the time a woman reaches age 85. That risk is much lower in younger women, but the disease can and does develop in women in their 20s to 40s.
Unfortunately, there are no reliable techniques yet available for early detection. That means three-fourths of patients with ovarian cancer are diagnosed when they are already at stage 3. This is an advanced state of ovarian cancer that is more difficult to cure. Taking some form of birth control, most commonly “the pill” for 5 years or longer can reduce your risk of developing ovarian cancer. But how does it work?
How can birth control help prevent ovarian cancer?
When a woman ovulates (releases eggs before her monthly period), there is a disruption of the surface of the ovaries.
Imagine a light switch. Every cycle, the switch is flipped on when a woman ovulates, then is flipped back off for maintenance and repair in the ovaries between cycles. The more the switch is flipped over time, the more chances it has to “get stuck” in the repair mode, when cells are replenishing and quickly growing, which can lead to ovarian cancer.
When a woman uses contraceptives, she rarely ovulates. This decreases the number of times the switch is flipped over her lifetime, thus decreasing her risk of ovarian cancer.
Many women worry about the consequences of taking birth control long term. Yes, it has its risks, as does any medication you may take. But it also has significant benefits in decreasing risk of ovarian cancer. It is always important to have a conversation with your doctor about the risks and benefits of taking long term birth control before starting any new medications.
Reducing your risk with tubal resection surgery
In the past, tubal ligation (having your tubes tied) was the preferred method for preventing ovarian cancer. However, the tubes themselves turned out to be the source of cancer in many cases.
With the discovery of the BRCA gene mutation and increased frequency of testing, many women who tested positive were having hysterectomies (removal of the ovaries, fallopian tubes, and uterus) to decrease their risk of ovarian cancer. The removed organs were tested, and in early 2014, it was discovered that 30 to 60 percent of ovarian cancers started in the fallopian tubes.
Because of these findings, our clinic performs only tubal resection as a means for preventing ovarian cancer. Removing the most common originating point for ovarian cancer is effective. We still offer tubal ligation to prevent pregnancy, but we do not recommend it to prevent ovarian cancer.
Family planning and tubal resection
Women have several things to consider before opting for tubal resection. Removing or severing the fallopian tubes is not harmful to the body. However, unlike having your tubes tied, tubal resection is irreversible. If you have tubal resection, you will not be able to get pregnant in the future.
It is important to discuss family planning with your partner before taking this step. If you feel confident that you do not wish to get pregnant again and you have a family history of ovarian cancer, tubal resection may be an option to consider.
We may not know a lot about what causes ovarian cancer, and we may not yet have a reliable way to find it early, but we do have strategies to help prevent it. If you are concerned about your ovarian cancer risk, speak with your doctor about using the birth control pill or tubal resection to decrease your risk.
Tags: cancer, cancer prevention, family health, women's health