Ask Karen: Birth control and hormone replacement

By Karen McNew
WSLS10 Anchor
Published: March 19, 2008

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Dear Karen,
Could you please look into the differences and similarities between birth control pills and hormone replacement therapy?  Why is one associated with an increased risk of breast cancer and not the other?

Thanks,
Cathy J.
Forest

A:  Unfortunately, there is no simple answer to your question.  I’ve found hormone therapy is actually a lower dose of hormones than birth control pills.  Dr. Abby Smith with Western Virginia OBGYN tells me that all of the studies out there show birth control pills don’t make the risk for breast cancer higher or lower.

“I’m not sure if it is the timing of things, taking hormone therapy later in life,” says Dr. Smith.

The Women’s Health Initiative study is what caused concerns about taking hormone therapy.

Dr. Smith says, “Right now by the standards, we are strictly supposed to use it to relieve menopausal symptoms.”

Before, hormone therapy was prescribed to help with bone building to protect against osteoporosis and in some cases heart disease.

Dr. Smith says there may be a slight increased for risk of breast cancer with hormone therapy but that The Women’s Health Initiative was a terrible study.

Regardless, both birth control pills and hormone therapy make clots more likely to form, so for older patients there is an increased risk for stroke.

And for women who have a family history of ovarian cancer, birth control pills have been shown to lower the risk for that disease.

The best way to determine the benefits and risks to taking either form of hormones is to talk to your doctor about your medical history and what is best suited for your needs.