My doctor won’t give me Hormone Replacement Therapy to help relieve my menopause symptoms. He says those hormones are associated with increased health risks. Yet, if I were 40 years younger and asked the doctor for oral contraception, he would prescribe it in a snap. Even though hormone replacement therapy and oral contraceptives consist of similar hormones with similar risks for cancer and other illnesses.
The World Health Organization has classified oral contraceptives as Group 1 carcinogens since at least 2005. However, they issued a public statement, attempting to reassure the public:
As stated in IARC’s review, the use of COCs (Combined Oral Contraceptives) modifies slightly the risk of cancer, increasing it in some sites (cervix, breast, liver), decreasing it in others (endometrium, ovary). Some of these data refer to older higher-dose COC preparations. Assessments based on risk-benefit calculations are carried out by different teams within WHO. Several WHO committees work on creating evidence-based family planning guidelines and on keeping them up-to-date on a continuous basis. They regularly review the safety of COCs and assess the balance of risks and benefits of COC use and they have determined that for most healthy women, the health benefits clearly exceed the health risks. [1]
Ah, I feel so much better, now that the experts have weighed in. Why don’t I get to evaluate those risks myself, in consultation with my own doctor?
Let’s look at the monograph produced by the International Agency for Research on Cancer,
There is sufficient evidence in humans for the carcinogenicity of combined oral estrogen–progestogen contraceptives. This evaluation was made on the basis of increased risks for cancer of the breast among current and recent users only, for cancer of the cervix and for cancer of the liver in populations that are at low risk for hepatitis B viral infection.
There is evidence suggesting lack of carcinogenicity in humans for combined oral estrogen–progestogen contraceptives in the endometrium, ovary and colorectum.
There is convincing evidence in humans for their protective effect against carcinogenicity in the endometrium and ovary. [2]
After summarizing the evidence of carcinogenicity of various hormones in animal trials, the monograph concludes:
Overall evaluation
Combined oral estrogen-progestogen contraceptives are carcinogenic to humans (Group 1). There is also convincing evidence in humans that these agents confer a protective effect against cancer of the endometrium and ovary.
Mind you, this is not an internet sheet put out by some fly-by-night religious organization. This is the World Health Organization’s premier organization for evaluating information regarding the causes of cancer. This report was over 500 pages long, and was the result of the participation of experts from all over the world.[3]
Nonetheless, they attempt to reassure the public that the risks of breast, cervix and liver associated with The Pill are acceptable, because it seems to offer some protection against cancers of the endometrium and ovary.
Contrast this conclusion with the much stronger statement made in the very same publication, regarding Menopausal Hormone Replacement Therapy:
5.5 Evaluation
There is sufficient evidence in humans for the carcinogenicity of combined estrogen–progestogen menopausal therapy in the breast.
There is evidence suggesting lack of carcinogenicity in humans for combined estrogen-progestogen menopausal therapy in the colorectum.
There is sufficient evidence in humans for the carcinogenicity of combined estrogen–progestogen menopausal therapy in the endometrium when progestogens are taken for fewer than 10 days per month, and there is evidence suggesting lack of carcinogenicity in the endometrium when progestogens are taken daily. The risk for endometrial cancer is inversely associated with the number of days per month that progestogens are added to the regimen.
Overall evaluation
Combined estrogen–progestogen menopausal therapy is carcinogenic to humans
(Group 1).[4]
No fooling around in that Overall Evaluation. No balancing of costs and benefits. No reassurance that women who can’t sleep at night because of hot flashes will probably be ok, and the health benefits of getting a good night’s sleep outweigh the risks of cancer.
I do not know why the staff of the World Health Organization and the International Agency for Research on Cancer, are offering such a sanguine view of hormones used for contraceptive purposes, in comparison with hormones taken for the comfort of menopausal women. Maybe they are more concerned about the health of older women than of younger women. maybe they cannot imagine women of child-bearing age living without contraception. I do not know.
I do know this: The Sexual Revolutionaries wish to create a world in which sex does not make babies. This ideology is not even remotely plausible unless contraception works perfectly at no cost. They need to convince themselves that The Pill is safe.
But the rest of us deserve to know the whole story.
[1] “Carcinogenicity of combined hormonal contraceptives and combined menopausal treatment,” Statement from the Department of Reproductive Health and Research, World Health Organization, September 2005.
http://www.who.int/reproductivehealth/topics/ageing/cocs_hrt_statement.pdf Last accessed, November 29, 2013.
[2] Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy IARC MONOGRAPHS ON THE EVALUATION OF CARCINOGENIC RISKS TO HUMANS, vol 91 (2007), page 175. A 164 page extract from this full 500 page report can be found at this web address: http://monographs.iarc.fr/ENG/Monographs/vol91/mono91-6E.pdf (IARC stands for “International Agency for Research on Cancer.” The Agency is part of the World Health Organization.
[3] Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy IARC MONOGRAPHS ON THE EVALUATION OF CARCINOGENIC RISKS TO HUMANS, vol 91 (2007) See pp. 3-5 for a complete list of participants in the conference which produced this volume.
[4] Combined Estrogen-Progestogen Contraceptives and Combined Estrogen-Progestogen Menopausal Therapy IARC MONOGRAPHS ON THE EVALUATION OF CARCINOGENIC RISKS TO HUMANS, vol 91 (2007) http://monographs.iarc.fr/ENG/Monographs/vol91/mono91-6.pdf
