Segarra, I., Menárguez, M., & Roqué, M. V. (2023). Women's health, hormonal balance, and personal autonomy. Frontiers in Medicine, 10, 1167504. https://doi.org/10.3389/fmed.2023.1167504
Segarra I, Menárguez M, Roqué MV. Women's health, hormonal balance, and personal autonomy. Front Med (Lausanne). 2023;10:1167504. doi:10.3389/fmed.2023.1167504
Segarra, Ignacio, et al. "Women's health, hormonal balance, and personal autonomy." Frontiers in Medicine, vol. 10, 2023, pp. 1167504.
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Hormone-based contraception is linked to mood, clot and cancer risks
A 2023 review of published studies links hormone-based contraception (HBC) to mood, blood clot and cancer risks. In one cited study of 815,662 women aged 12 to 30, HBC users received psychotropic drugs more often: 37 out of 1,000 versus 25 out of 1,000.
Key Findings
Among 815,662 women aged 12 to 30, psychotropic drugs were dispensed to 3.7% of HBC users and 2.5% of non-users (relative risk 1.34, 95% CI: 1.30–1.37).
Among 475,802 Danish women aged 15 to 33 using HBC, first suicide attempts carried a relative risk of 1.97 (95% CI: 1.85–2.1), and suicides 3.08 (95% CI: 1.34–7.08).
Across 1.8 million women followed nearly 11 years, breast cancer incidence relative risk was 1.20 (95% CI: 1.14–1.26) for HBC users.
Cervical cancer relative risk rose with duration of HBC use: 1.1 (95% CI: 1.1–1.2) under 5 years, 1.6 (95% CI: 1.4–1.7) for 5 to 10 years, 2.2 (95% CI: 1.9–2.4) beyond 10.
Interpretation
This review examined published research on hormone-based contraception (HBC) and presents the findings as associations between HBC use and risks to mood, blood clots and cancer. The authors argue for an anthropological view of sexuality in their closing discussion. The findings support further research into these associations in women using HBC.
RRM Context
The review says HBC puts women in an artificial state without ovulation. Restorative reproductive medicine treats a regular ovulatory cycle as a sign of health and aims to restore it. Suppressive medications such as HBC set that cycle aside. The authors report that information on cardiovascular risks stresses efficacy and use, with minimal attention to adverse effects.
Our editorial summary of this paper, not the article's abstract.
Abstract
Hormone-based contraception disrupts hormonal balance, creating artificial states of anovulation and threatening women's health. We reviewed its main adverse effects and mechanisms on accelerated ovarian aging, mental health (emotional disruptions, depression, and suicide), sexuality (reduced libido), cardiovascular (brain stroke, myocardial infarction, hypertension, and thrombosis), and oncological (breast, cervical, and endometrial cancers). Other "collateral damage" includes negative effects on communication, scientific mistrust, poor physician-patient relationships, increased patient burden, economic drain on the healthcare system, and environmental pollution. Hormone-sensitive tumors present a dilemma owing to their potential dual effects: preventing some cancers vs. higher risk for others remains controversial, with denial or dismissal as non-relevant adverse effects, information avoidance, and modification of scientific criteria. This lack of clinical assessment poses challenges to women's health and their right to autonomy. Overcoming these challenges requires an anthropological integration of sexuality, as the focus on genital bodily union alone fails to encompass the intimate relational expression of individuals, complete sexual satisfaction, and the intertwined feelings of trust, safety, tenderness, and endorsement of women's femininity.
