On the March 9, 2012 Dr. Oz show there were clips from a Dr. Laura Zimmermann who prescribes birth control pills to women 40 years and older. There were also clips of a couple of women saying the pill stopped their peri-menopausal symptoms (hot flashes, night sweats, migraines). Dr. Oz said that more than 80% of women have taken birth control pills at one time or the other in their lives and then stopped. He went on to say that on average a woman releases 520 eggs in a lifetime (if not on the pill or pregnant) and the more eggs that are released, the more the risk of ovarian cancer. Columbia University’s Medical Center’s Dr. Carolyn Westhoff, and Arizona MD Anderson Cancer Center’s Dr. Judith Wolf were on the show. Dr. Wolf said that women didn’t ovulate as much as women do today, they didn’t start their periods as early (last year Sara Gilbert said hormones in animal feed and bendable plastic are making girls reach puberty as young as 7 years old), didn’t live as long – had more children (don’t ovulate when pregnant or nursing) and using the pill puts us back to where we were years ago. Dr. Westhoff explained that the pill, made up of estrogen and progesterone, puts the ovaries to sleep. Dr. Oz explained that each time an egg is released it creates scarring and excess scarring can cause ovarian cancer; the natural rise and fall of the uterus lining can cause endometrial cancer. The pill slows the growth of the lining of the uterus and prevents the egg from being released in the ovaries. Dr. Wolf said if a woman takes the pill for at least 5 years over her lifetime 50% of both cancers are prevented; she said it doesn’t matter when the pill is taken because the effects of the pill last a lifetime. Dr. Oz said colon rectal cancer is prevented by 20% with the pill (Dr. Wolf said it has the same effect on the colon’s lining as with the uterus lining). (On October 28, 2011 a study found long-term aspirin use [2 a day] could reduce colon risk by 60% for some high risk patients.) Dr. Westhoff said 5 years is fine but taking the pill for longer is better and agreed with Dr. Zimmermann that women in their 40s can benefit from taking the pill. Dr. Westhoff also said that with the studies done over the years we now know that taking the pill does not change the breast cancer risk; there is a tiny increase in risk during the time of taking the pill but it’s gone when the pill is stopped so the net effect over a lifetime is no change. Dr. Westhoff said cervical cancer has a slight increase in risk when women take the pill but with regular Pap tests (every 2 years) a change is caught early before it turns into cancer. (On March 15 new Pap Test Guidelines came out saying: 21-29 every 3 years, 30-65 every 3 years or an HPV test and Pap test every 5 years if both are negative). Dr. Wolf said for women early on or later taking the pill results in less irregular or heavy periods, less anemia, less cramping, a decrease in mood swings with premenstrual or peri-menopause cycles, and some decrease acne. Dr. Westhoff said the pill has benefits even if it’s used for a year or 2 but they substantial benefits come if used for 5 years or longer. Dr. Oz mentioned that there is now an extended cycle pill and asked if there would be a problem with not having a period for months at a time; Dr. Wolf said there is no danger if you didn’t have a period for 5 years or more unless a woman goes through premature menopause (menopause before the age of 40).
Dr. Westhoff explained that women in their 40s are still prone to pregnancy and peri-menopausal symptoms and that’s why she thinks the pill is better than hormones; she said when the eggs are gone then hormone therapy to deal with the peri-menopausal symptoms is okay; taking the pill until 50 or 52 is okay as long as the woman is otherwise healthy; hormone therapy doesn’t reduce ovarian cancer. Dr. Westhoff said for most women the benefits of the pill will outweigh the risks by a very large amount; in women in their 40s it helps to prevent bone loss. (On October 27 it was reported that a study found that hormones thwart weight loss efforts).
Dr. Wolf said women who shouldn’t take the pill are: those over 35 who smoke because there’s an increase in cardiovascular complications (under 35 is okay), those that have a history of blood clots in the legs or lungs clots (otherwise the risk in women over 35 is low) and those that have already had cancer. FYI - on November 1, 2011 per JAMA a study of 100,000 women over 28 years found that even one glass of alcohol per day raises your risk of breast cancer; 3 – 6 glasses per week raises the risk 15%; 2 glasses per day increases the risk to 51%. Oxford University thought that 11% of breast cancers were linked to alcohol usage. (Moderate alcohol helps to prevent heart attacks and strokes) Dr. Otis Brawley of the American Cancer Foundation said the increased risk in breast cancer is really dwarfed in comparison to the decrease in cardiovascular disease. ABC’s Dr. Besser said 1 in 3 women die from heart disease and 1 in 36 women die from breast cancer. If you’re not at high risk for breast cancer, weigh the odds, and if you don’t drink now, nobody is telling you to start.
Because of the new information saying birth control is not just a contraceptive but used for other medical issues there is internet frenzy regarding Arizona’s House Bill 2625 and other states’ bills making birth control solely a religious issue. I will begin a 5 part story regarding HB 2615 and some of the other bills tomorrow.
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