Long-acting contraceptives seem to be as safe as the pill when it comes to cancer risk
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Many women worry hormonal contraceptives have dangerous side-effects including increased cancer risk. But this perception is often out of proportion with the actual risks.
So, what does the research actually say about cancer risk for contraceptive users?
And is your cancer risk different if, instead of the pill, you use long-acting reversible contraceptives? These include intrauterine devices or IUDs (such as Mirena), implants under the skin (such as Implanon), and injections (such as Depo Provera).
Our new study, conducted by the University of Queensland and QIMR Berghofer Medical Research Institute and published by the Journal of the National Cancer Institute, looked at this question.
We found long-acting contraceptives seem to be as safe as the pill when it comes to cancer risk (which is good news) but not necessarily any safer than the pill.
How does the contraceptive pill affect cancer risk?
The International Agency for Research on Cancer, which compiles evidence on cancer causes, has concluded that oral contraceptives have mixed effects on cancer risk.
Using the oral contraceptive pill:
- slightly increases your risk of breast and cervical cancer in the short term, but
- substantially reduces your risk of cancers of the uterus and ovaries in the longer term.
Our earlier work showed the pill was responsible for preventing far more cancers overall than it contributed to.
In previous research we estimated that in 2010, oral contraceptive pill use prevented over 1,300 cases of endometrial and ovarian cancers in Australian women.
It also prevented almost 500 deaths from these cancers in 2013. This is a reduction of around 25% in the deaths that could have occurred that year if women hadn’t taken the pill.
In contrast, we calculated the pill may have contributed to around 15 deaths from breast cancer in 2013, which is less than 0.5% of all breast cancer deaths in that year.
What about long-acting reversible contraceptives and cancer risk?
Long-acting reversible contraceptives – which include intrauterine devices or IUDs, implants under the skin, and injections – release progesterone-like hormones.
These are very effective contraceptives that can last from a few months (injections) up to seven years (intrauterine devices).
Notably, they don’t contain the hormone oestrogen, which may be responsible for some of the side-effects of the pill (including perhaps contributing to a higher risk of breast cancer).
Use of these long-acting contraceptives has doubled over the past decade, while the use of the pill has declined. So it’s important to know whether this change could affect cancer risk for Australian women.
Our new study of more than 1 million Australian women investigated whether long-acting, reversible contraceptives affect risk of invasive cancers. We compared the results to the oral contraceptive pill.
We used de-identified health records for Australian women aged 55 and under in 2002.
Among this group, about 176,000 were diagnosed with cancer between 2004 and 2013 when the oldest women were aged 67. We compared hormonal contraceptive use among these women who got cancer to women without cancer.
We found that long-term users of all types of hormonal contraception had around a 70% lower risk of developing endometrial cancer in the years after use. In other words, the risk of developing endometrial cancer is substantially lower among women who took hormonal contraception compared to those who didn’t.
For ovarian cancer, we saw a 50% reduced risk (compared to those who took no hormonal contraception) for women who were long-term users of the hormone-containing IUD.
The risk reduction was not as marked for the implants or injections, however few long-term users of these products developed these cancers in our study.
As the risk of endometrial and ovarian cancers increases with age, it will be important to look at cancer risk in these women as they get older.
What about breast cancer risk?
Our findings suggest that the risk of breast cancer for current users of long-acting contraceptives is similar to users of the pill.
However, the contraceptive injection was only associated with an increase in breast cancer risk after five years of use and there was no longer a higher risk once women stopped using them.
Our results suggested that the risk of breast cancer also reduces after stopping use of the contraceptive implants.
We will need to follow-up the women for longer to determine whether this is also the case for the IUD.
It is worth emphasising that the breast cancer risk associated with all hormonal contraceptives is very small.
About 30 in every 100,000 women aged 20 to 39 years develop breast cancer each year, and any hormonal contraceptive use would only increase this to around 36 cases per 100,000.
What about other cancers?
Our study did not show any consistent relationships between contraceptive use and other cancers types. However, we only at looked at invasive cancers (meaning those that start at a primary site but have the potential to spread to other parts of the body).
A recent French study found that prolonged use of the contraceptive injection increased the risk of meningioma (a type of benign brain tumour).
However, meningiomas are rare, especially in young women. There are around two cases in every 100,000 in women aged 20–39, so the extra number of cases linked to contraceptive injection use was small.
The French study found the hormonal IUD did not increase meningioma risk (and they did not investigate contraceptive implants).
Benefits and side-effects
There are benefits and side-effects for all medicines, including contraceptives, but it is important to know most very serious side-effects are rare.
A conversation with your doctor about the balance of benefits and side-effects for you is always a good place to start.
Susan Jordan, Professor of Epidemiology, The University of Queensland; Karen Tuesley, Postdoctoral Research Fellow, School of Public Health, The University of Queensland, and Penny Webb, Distinguished Scientist, Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Peanuts vs Macadamias – Which is Healthier?
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Our Verdict
When comparing peanuts to macadamias, we picked the peanuts.
Why?
In terms of macros, peanuts have more than 3x the protein while macadamias have a lot more fat. It’s mostly healthy monounsaturated fat, but all the same, we’ll prioritize the protein over the fat, which becomes the deciding factor since they are approximately equal on carbs and fiber. So, a subjective win for peanuts in this category.
In the category of vitamins, peanuts have a lot more of vitamins B3, B5, B6, B9, E, and choline, while macadamias have slightly more of vitamins B1, B2, and C. A clear and convincing win for peanuts.
When it comes to minerals, peanuts have more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while macadamias have more manganese. An overwhelming win for peanuts.
Adding up the sections with their various degrees of win for peanuts, makes for an overall absolute win for peanuts, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Enjoy!
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Yoga for Better Sleep – by Mark Stephens
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The book has, as you might expect:
- postural exercises
- breathing exercises
- meditation exercises
Instructions given in all of the above categories are clear and easy to follow, and there are photographic illustrations too where appropriate.
What sets it apart from many books of this kind is that it also has chapters dedicated to various specific circumstances; the many actual reasons people seriously struggle to sleep; not just “screentime too late”, but for example deprepression, sleep apnea, hyperarousal, or even just aging.
As well as the comprehensive exercises, there are also many tips, tricks, hacks, and workarounds—it’s a practical guidebook with practical advice.
While the book is about yogic practices, the author also does tackle this holistically, acknowledging that there are many factors going on, and that yogic practices should be one more string to our sleep-improving bow—as we continue with other general good advice for good sleep too, have medical tests if it seems appropriate, that kind of thing. Basically, to have one’s assorted approaches work together with synergistic effect.
Bottom line: this book will quite possibly put you to sleep! But only in the best possible way.
Click here to check out Yoga for Better Sleep, and get those valuable Zs in, healthily!
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Coca-Cola vs Diet Coke – Which is Healthier?
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Our Verdict
When comparing Coca-Cola to Diet Coke, we picked the Diet Coke.
Why?
While the Diet Coke is bad, the Coca-Cola has mostly the same problems plus sugar.
The sugar in a can of Coca-Cola is 39g high-fructose corn syrup (the worst kind of sugar yet known to humanity), and of course it’s being delivered in liquid form (the most bioavailable way to get, which in this case, is bad).
To put those 39g into perspective, the daily recommended amount of sugar is 36g for men or 25g for women, according to the AHA.
The sweetener in Diet Coke is aspartame, which has had a lot of health risk accusations made against it, most of which have not stood up to scrutiny, and the main risk it does have is “it mimics sugar too well” and it can increase cravings for sweetness, and therefore higher consumption of sugars in other products. For this reason, the World Health Organization has recommended to simply reduce sugar intake without looking to artificial sweeteners to help.
Nevertheless, aspartame has been found safe (in moderate doses; the upper tolerance level would equate to more than 20 cans of diet coke per day) by food safety agencies ranging from the FDA to the EFSA, based on a large body of science.
Other problems that Diet Coke has are present in Coca-Cola too, such as its acidic nature (bad for tooth enamel) and gassy nature (messes with leptin/ghrelin balance).
Summary: the Diet Coke is relatively less unhealthy, but is still bad in numerous ways, and remains best avoided.
Read more:
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Jackfruit vs Durian – Which is Healthier?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Our Verdict
When comparing jackfruit to durian, we picked the durian.
Why?
Durian may look and smell like it has come directly from Hell, but there’s a lot of goodness in there!
First, let’s talk macros: jackfruit and durian are both unusually high in protein, for fruits. That said, jackfruit does have slightly more protein—but durian has more than 2x the fiber, for only slightly more carbs, so we call this section a win for durian.
Like most fruits, these two are an abundance source of vitamins; jackfruit has more of vitamins A and E, while durian has more of vitamins B1, B2, B3, B9, and C. Another win for durian.
When it comes to minerals, jackfruit has more calcium, while durian has more copper, iron, manganese, phosphorus, and zinc. We don’t usually measure this one as there’s not much in most foods (unless added in artificially), but durian is also high in sulfur, specifically in “volatile sulfur compounds”, which account for some of its smell, and are—notwithstanding the alarming name—harmless. In any case, mineral content is another win for durian.
These three things add up to one big win for durian.
There is one thing to watch out for, though: durian inhibits aldehyde dehydrogenase, which the body uses to metabolize alcohol. So, we recommend you don’t drink-and-durian, as it can increase the risk of alcohol poisoning, and even if alcohol consumption is moderate, it’ll simply stay in your system for longer, doing more damage while it’s there. Of course, it is best to simply avoid drinking alcohol regardless, durian or no durian, but the above is good to know for those who do imbibe.
A final word on durians: if you haven’t had it before, or had it and it was terrible, then know: much like a banana or an avocado, durian has a rather brief “ideal ripeness” phase for eating. It should be of moderate firmness; neither tough nor squishy. It should not have discolored spikes, nor should it have little holes in, nor be leaking fluid, and it should not smell of sweat and vinegar, although it should smell like sulfurous eggs, onions, and cheese. Basically, if it smells like a cheese-and-onion omelette made in Hell, it’s probably good. If it smells like something that died and then was kept warm in someone’s armpit for a day, it’s probably not. The best way to have a good first experience with a durian is to enjoy one with someone who knows and enjoys durians, as they will be able to pick one that’s right, and will know if it’s not (durian-sellers may not necessarily have your best interests at heart, and may seek to palm off over-ripe durians on people who don’t know better).
Enjoy!
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
Take care!
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Most People Who Start GLP-1 RAs Quit Them Within A Year (Here’s Why)
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Specifically, 54% quit within one year, with that number rising to 72% within two years.
We first wrote about GLP-1 receptor agonists (i.e. semaglutide drugs like Ozempic and Wegovy) a couple of years ago when popularity was just beginning to take off:
However, as we had room only to touch briefly on the side effects and what happens when you stop taking it, you might also want to check out:
What happens when I stop taking a drug like Ozempic or Mounjaro?
…and:
Notwithstanding all this information, there’s a lot of science that has still yet to be done. If you’re a regular 10almonds reader, you’ll be familiar with our research review articles—this one was more of a non-research review, i.e. looking at the great absence of evidence in certain areas, and the many cases of research simply not asking the right questions, for example:
❝Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!
It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.
A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.❞
Read in full: Semaglutide’s Surprisingly Unexamined Effects ← there are a lot more (equally concerning) items discussed in this article
Why people quit GLP-1 RAs
There was a large (n=125,474) study of US adults. The average age was about 54 years, and about 65% were female.
From the total data pool (i.e. not narrowing it down by demographic), 54% stopped within a year, and 72% within two years.
The factors most associated with discontinuation were:
- age above 65 years
- not having type 2 diabetes
The main reasons given for discontinuation were:
- High costs: self-explanatory, but it’s worth noting that people who stopped for this reason were more likely to restart later.
- Adverse side effects: the most common ones were nausea, vomiting, diarrhea, constipation, stomach pain, and loss of appetite. Rarer, but more seriously, side effects included: pancreatitis (severe abdominal pain, nausea, vomiting), gallbladder issues (gallstones, cholecystitis), kidney problems, severe allergic reactions (rash, swelling, difficulty breathing), hypoglycemia, especially if taken with insulin or other diabetes medications, changes in vision (worsening diabetic retinopathy), and an increased heart rate.
- Disappointingly little weight loss: the researchers noted that GLP-1 RA results are “heterogenous”, meaning, they differ a lot. For those for whom it didn’t work, quitting was more likely, for obvious reasons. See also: 10 Mistakes To Sabotage Your Ozempic Progress
- Successful weight loss: while it is widely known that if one stops taking GLP-1 RAs, weight regain is the usual next thing to happen, there are a lot of people who go onto GLP-1 RAs with the rationale “I’ll just use this to lose the weight, and then I’ll keep the weight off with my diet and lifestyle”. Which sounds reasonable, but because of the specific mechanisms of actions of GLP-1 RAs, it simply doesn’t work that way (and, as we mentioned above, there are reasons that you may, after stopping taking GLP-1 RAs, be more disposed to put weight on than you were before you started). So, by the best of current science (which admittedly is not amazing when it comes to this topic), it does seem that taking GLP-1 RAs is a lifetime commitment.
You can read the study itself here:
Want to get similar results, without GLP-1 RAs?
Then check out:
5 Ways To Naturally Boost The “Ozempic Effect” ← this is about natural ways of doing similar hormone-hacking to what GLP-1 RAs do
and
Ozempic vs Five Natural Supplements ← this is about metabolism-tweaking supplements
and
Hack Your Hunger ← this is about appetite management
Take care!
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The Plant-Based Diet Revolution – by Dr. Alan Desomond
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Is this just another gut-healthy cooking guide? Not entirely…
For a start, it’s not just about giving you a healthy gut; it also covers a healthy heart and a healthy brain. There’s lots of science in here!
It’s also aimed as a transitional guide to eating more plants and fewer animal products, if you so choose. And if you don’t so choose, at least having the flexibility to cook both ways.
The recipes themselves (organized into basics, breakfasts, lunches, mains, desserts) are clear and easy while also being calculated to please readers (and their families) who are used to eating more meat. There are, for instance, plenty of healthy proteins, healthy fats, and comfort foods.
The “28 days” of the title refers to a meal plan using the recipes from the book; it’s not a big feature of the book though, so use it or don’t, but the cooking advice itself is more than worth the price of the book and the recipes are certainly great.
Bottom line: if you’re thinking of taking a “Meatless Mondays” approach to making your diet healthier, this book can help you do that in style!
Click here to check out The Plant-Based Diet Revolution, and upgrade your culinary repertoire!
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