So -- I'm curious how many of you are on birth control pills or any other birth control devices, such as IUD's that give out hormones -- progesterone or estrogen or a combination?
From what I've been reading, use of these increases the risk of HPV persistence even more than smoking. It's the persistence of HPV that leads to dysplasia and eventually cervical cancer (if untreated).
I've read that these hormones disrupt something called the E2 protein on HPVDNA. E2 is necessary because it causes death in damaged cells. Without E2 the bad cells can then proliferate. Something called E6 is involved also, but I don't really understand that part.
I'm wondering if doctors routinely talk to you about these risks if you're on any kind of hormonal contraceptives? That might include IUD's which release hormones as well, but I'm not sure about the IUD's. I couldn't find specifically whether different types of birth control pills made a difference -- such as ones that have both progesterone & estrogen versus ones that are progesterone only.
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HPV & Birth Control Pills
- By corellin
- Posted May 3, 2008 at 8:03 pm · 23 replies
- In HPV/cervical cancer vaccine prevention strategies
- Shared with the public
Explore topics in this discussion:
Cancer Surgery Pregnancy Ovarian cancer Menopause Ethinyl estradiol and norgestimate Progesterone Folic acid Ovarian cysts Stress Hysterectomy Ortho tri-cyclen Stroke Ectopic pregnancy Viagra Cervical cancer Breast cancer HPV Estradiol
23 replies
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- By chamomile
- Posted May 3, 2008 at 10:14 pm
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I took birth control pills for 10.5 years straight. No one every discussed the increased risk of cc with me. It was not until after I was diagnosed a couple of months ago and researched the issue that I asked the doctors who confirmed that there is a connection. I took these pills during (sometimes long) periods of abstinence...mostly to regulate my periods. No one ever mentioned this connection even when I was diagnosed with high risk HPV 5 years ago. I was only told about the risk of stroke etc. However, my paps were all normal after that (until this year)....so I was told I must have cleared the virus. I was diagnosed with adenocarcinoma in February :( Hindsight is 20/20, but I wish I would have been told the risks.
- By kb1200
- Posted May 3, 2008 at 10:15 pm
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That's really interesting. I am 40 and I have never had an abnormal pap til Feb 08 when I was diagnosed with AIS. I was on birth control pills for a short time in my early 20s but was off them until 4 years ago. Looking at your post makes me wonder if something like that could have contributed?
- By corellin
- Posted May 3, 2008 at 10:31 pm
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kb -- probably did not contribute, because you used them for such a short time and discontinued them so long ago. Risk increases the more years you use them and then seems to go back down to 0 after 10 years of non-use.
chamomile -- your story just highlights to me the importance of finding out as much as possible about an HPV infection at the time it is active, and then adjusting the followup accordingly. For example, HPV18 tends to go up into the cervical canal more than any other type and cause adenocarcinoma, so if you had found out your HPV type, and if it was 18, the doctors should then know to do an ECC and check up in the cervical canal periodically. I'm curious what kind of followup they did for you over the past 5 years. Did you continue to have HPV tests as well as paps? Did they give you a colposcopy or ECC? Thanks for sharing!
- By Chavonia
- Posted May 4, 2008 at 9:49 am
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I am so glad you made this post because after I found out what was going on with me and its links to birth control, I was upset that in all the years I had been taking it (since I was 16 I am 24 now), no one ever mentioned these kinds of risks. I figured since the pill had been around for over 30 years that it was safe and that all possible side effects and correlative illness were clear cut and discussed. I think some gynecologists don't want to admit that hey, maybe some of these birth control methods are not as safe for long term use. They don't want to even tell you its correlated with cc and other serious issues.
Also, not everyone is required to get a pap smear to attain some forms of birth control. Perhaps if that was done, some people who are at higher risks for defects can be forewarned.
- By chamomile
- Posted May 4, 2008 at 10:50 am
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Corelin: I had an abnormal pap apx 11/02 and was told that I had "high risk" HPV. No one told me which kind or offered any other information. I had a colp a few weeks later but nothing was biopsied because nothing looked suspect. I had another abornmal Pap six months later and then another colp. Again, no biopsies were taken. Thereafter, i had Paps every six months for another year...but they were all normal. So, they had me go back to yearly Paps, all of which were normal until 2/08. I never even heard of adenocarcinoma before my diagnosis. During the last 5 years, I experienced a huge amount of stress in my life. I wish I would have known the seriousness of this....so that maybe I could have tried to deal with my stress and health. I think that my gyn assumed because I was young (I'm 30 now) and otherwise healthy, that I was not at risk and could rely on normal paps as foolproof. Only after I was diagnosed, was I told that Paps aren't terribly good at diagnosing adenocarcinoma OR that adenocarcinoma is on the rise in young women (many of whom have a history of long-term birthcontrol use)!! Over the years, I specifically asked my gyn several times if it is OK to stay on pills constantly for so long. She assurred me it was perfectly fine (I'm a non-smoker) and NEVER discussed cc given my history.
- By LaGata
- Posted May 4, 2008 at 11:34 am
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I took birth control pills for 21 straight years. Every couple of years my doctor would tell me that this study or that mentioned a "possible" increased cancer risk. I've never been diagnosed with HPV. Tested for it but all tests came back negative.
I stopped taking the pills in 1990 when diagnosed with cervical cancer and had a hysterectomy. Perhaps it also played a roll in being diagnosed with advanced breast cancer in 2005? We'll probably never know for sure.
- By corellin
- Posted May 4, 2008 at 11:50 am
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Chamomile -- thanks for sharing. It sounds like the doctors were being careful in that they gave you two colposcopies and paps every 6 months. I think the additional thing they could have done is given HPV tests (type-specific) and also checked up in the cervical canal with an endocercival curettage. But those aren't necessarily part of the normal protocol (and the type-specific HPV tests haven't been FDA approved yet). And I understand what you're saying about wishing you'd understood the seriousness.... Sometimes I think we all sit there like frogs in a pot of hot water and don't realize that we need to STOP and figure out what's going on in our bodies and fix it, rather than just rely on doctors and surgical intereventions (which aren't always effective and can have side effects).
Chavonia --I've also read a theory that birth control pills deplete folate so that perhaps you can counteract the affects of birth control pills by taking a folate supplement. (Too much folate can be bad for you, so I wonder if it's possible to measure folate levels in the body to make sure if you're getting enough.) If this turns out to be the case, then folate supplements should also be prescribed along with birth control pills. (Not sure whether that would completely counteract the effects of BC pills or not.)
- By Hemlock
- Posted May 4, 2008 at 12:10 pm
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Corellin ~ I took birth control pills for 26 years. The only risk I ever heard about was to be careful about blood clots in my legs. Now I know that that birth control pills inhibit the body's ability to absorb folic acid which is necessary to work with the body's DNA to grow new cells. As we all know now, the cervix is almost like skin in that the top cells slough off and new ones push up to take their place. Because of HPV, a weakened immune system, and a folic acid deficiency, my body was not able to make new cells so nothing was able to slough off or take the place of the damaged cells. Which is why I ended up with CIS and AIS.
- By miltie
- Posted May 4, 2008 at 12:57 pm
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Thanks for posting, Corellin. I took the pill for about 3 years in my 20's and then stopped when i was 25 because the hormonal swings from it made me not a nice person (to put it politely). When I was 26, I had a colposcopy and the biopsy results read moderate dysplasia. Against my doctors recommendations, I never followed up. That was a VERY DUMB decision, this I know, but I was in some sort of this can't happen to me denial. I finally had a re-pap this past December (at age 31) which showed ACUS and a biopsy which showed Severe Dysplasia. I had a LEEP in April and fortunately I had clean margins AND the biopsy downgraded to Moderate.
I couldn't tell you if getting off the pill made the difference or not....I have always been physically active, but throughout all those years, I was a regular smoker. I don't know if I have a good immune system, or if being off the pill slowed the growth, or I was just lucky.
However, i DO NOT recommend anyone to wait like I did. Looking back, the Paps, Biopsies, and LEEP were not as horrid as I thought they would be.
- By Nic1
- Posted May 4, 2008 at 5:11 pm
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hi
I was on the combined pill, however after being diagnosed with VIN 3 in february 08 the doctor has just put me on the progesterone only pill as was told by doctor that she would not be happy to prescribe me the combined pill as the estrogen can feed pre cancer conditions. I had never been warned of this risk, before I had this condition. However I will need to be looking at another method as this pill is making my periods totally haywire (every 2 weeks) sometimes less.
- By corellin
- Posted May 4, 2008 at 8:21 pm
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You know.... what about the pill for men?? Have they come out with that yet?
- By flowershoplady
- Posted May 4, 2008 at 8:42 pm
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i think the only pill for men they've developed so far is viagra! (ok...this is meant to be a joke...sort of)
- By JJJ
- Posted July 9, 2009 at 12:51 pm
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This is an old thread that I want to bring up again.
I have been seriously thinking about going off the pill since being diagnosed with CIN2 for which I got a LEEP 2 days ago since I have read a lot that the pill can have an affect on these things. I've used the pill for 5 years. I decided to look at the drug facts of the pill I'm on to see if it says anything about increased chance of cervical cancer & I found this very interesting:
What is Ortho Tri-Cyclen Lo (ethinyl estradiol and norgestimate)?
Ethinyl estradiol and norgestimate contains a combination of female hormones that prevent ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.
It causes changes in my CERVICAL MUCUS? I wonder if has something to do with the occurrence of CIN? Well, I for one am done with the pill. I know numerous woman take the pill with no cervical problems, but I have obviously have cervical issues so I don't want to take something that messes with my cervical mucus! Maybe that change in the mucus was what caused my cells to become abnormal once HPV was present! I am done with the pill!
- By junaberry1
- Posted July 9, 2009 at 5:28 pm
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i was on the pill, the patch and 2 yrs ago i got the iuc i was never told of any risk for cc or increase in cin...
- By Sophie-1977
- Posted July 9, 2009 at 6:10 pm
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Hi everyone,
This is an old topic but I see it's just come up again. One of the things that makes me most angry with doctors I've seen, both past and present, is their outright denial of any connection between birth control pills and the progression of dysplasia and/or development of cervical cancer. The docs I've seen are apparently stuck in the past and believe that the connection is behavioral -- that is, that women on the pill will possibly have more sex and more partners because they do not fear pregnancy.
I only had one nurse practitioner acknowledge a possible connection by saying that the pill will increase the size of a woman's transformation zone, which is of course so often the trouble spot where HPV wreaks havoc.
If I'd had any inkling of the pill-cervical cancer connection when I was diagnosed with high risk HPV in 2006, I wouldn't have waited a full year until I needed surgery to stop taking the pill. I've accumulated 7-8 years of pill use in my life, often during periods when I had no partners and simply didn't want to mess up my hormones by going off the pill.
What a mistake. The ten years it will take for my risk to go back down to normal can't pass quickly enough.
Does anyone else think it's the pharmaceutical companies' power that prevents this message from getting out? They're always playing up how the pill protects against ovarian cancer -- it's the least they could do to be honest and say that at the same time it increases cervical cancer risk.
Sophie
- By corellin
- Posted July 10, 2009 at 2:39 am
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Sophie -- I don't think it's the pharmaceutical companies, but is rather just the doctors, who routinely prescribe birth control pills to women of childbearing years. It's a major part of their job (contraception prescribing), and I think they weigh the benefit of birth control pills against the risk and most doctors don't think that HPV poses much risk to most women, compared to the benefit of having the option of using hormonal contraceptives. But I think doctors really need to give women information and then let women make up their own mind about the tradeoffs. I also think that earlier studies showed conflicting evidence and it has only been more recently that some large analyses (comparing lots of studies) have more conclusively demonstrated the connection between oral contraceptives and an increased risk in in situ and invasive cervical cancer. It seems to me use > 5 years and >10 years that cause the most problem. It's possible that less than 5 years is not much of a problem, so it's less likely that they contribute to lower levels of dysplasia and more likely they impact progression to in situ or carcinoma. And, the impact seems to be greater in developing countries that have less cervical cancer screening. If a woman has a procedure that results in clearance of the active HPV infection, I think I read somewhere that her risk of in situ (CIS) or cervical cancer is not greater, but I'm not sure I'm remembering that correctly. So it's an active HPV infection combined with long-term use of hormonal contraceptives (> 5 years and >10 years) that seems to increase the risk the most. Once HPV is no longer active, then risk should immediately decrease, regardless of how long it has been since you stopped taking hormonal contraceptives (I think).
- By cupcakes
- Posted July 11, 2009 at 2:04 pm
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I'm currently taking progestin-only pills although it would have been nice to have been informed by my doctor of all the increased risk that came with taking hormonal birth control, I did know about the cervical cancer risk from reading the leaflet that comes in the package with my pills. When I saw this post I figured maybe I should reread it since I now know that I already have "precancerous" changes to my cervix. This is what it states "Some studies have found an increase in the incidence of cancer of the cervix in women who use oral contraveptives and there is insufficient data to determine whether the use of POPs increases the risk of developing cancer of the cervix."
The list of risks is Ectopic pregnancy, ovarian cysts, cancer of the reproductive organs and breast, and liver tumors.
It also says breast cancer is the one studies have shown pill users have an increased risk of developing for 10 years after quiting use.
I would love to quit using hormanal birth control but what other options do we really have? Other than condoms? I think I want to have more children someday just not now.
- By hopeandprayers
- Posted July 11, 2009 at 5:27 pm
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I took birth control pills for almost 25 yrs. My gynocologist never told me that they could increase the risk of any cancer, except breast, but that the dosage I was taking I wasn't at risk. They only thing he did tell me was that after I turned 35, they would not let me take them if I was a smoker, which I wasn't. I think my gyno. would've given them to me until I went through menopause. He said the benefits out weighed all the risks. The minute he suspected something was wrong, he made me stop taking birth control pills immediately. I wish I would've had a different gyno. when I look back on things now. He recently passed away. He was 71 yrs. old. I don't think he was as up to date on things the way he should've been. I never missed a pap since I was 18. If he would've ever suggested that I needed a hysterectomy to prevent cancer I would've done it. I trusted him, he should've known these things. That is their job and what we pay them for.
- By brieaukirsch
- Posted July 11, 2009 at 7:42 pm
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I took BCP for approx. 4 years but I discontinued them prior to when I think I contracted hrhpv. It is well established that estrogen and progesterone can influence the progression of hrhpv infection and dysplasia: estrogen by causing massive cell proliferation and turnover, and progesterone with its immune-depressing properties. (I researched this out of my personal history with herpes, not hpv, but the same concept applies.) It is important to note that the genetic predisposition to developing dysplasia from hpv infection is still required for estrogen and progesterone to cause any damage. It is unlikely that BCP alone would cause one to develop cancer without the genetic makeup. As for risk dropping over 5-10 years, like Corellin said, I would think once your body clears the hpv (whatever "clears" means) the risk drops immediately, however, I will never go back on BCP again due to my history of dysplasia.
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