ACOG reaffirmed a practice advisory in 2022 that had initially been in response to a prospective cohort study. The results from the paper by Mørch and colleagues (NEJM, 2017) was based on Danish nationwide registries (see ‘Related ObG Topics’ below) and identified the following
Overall risk of breast cancer in current or recent users compared to women who never used hormonal contraception
Oral Combined Contraceptives
Levonorgestrel-releasing intrauterine system (LNG-IUD)
Contraceptive implants
Absolute risks remain low
ACOG addresses these benefits clearly in this Practice Advisory
ACOG highlights the following
ACOG supports shared decision making and counseling should include the following
This recent study showed that women who use hormonal birth control methods may have a small increased risk of breast cancer, but the overall risk of breast cancer in hormonal birth control users remains very low
Hormonal birth control is very effective in preventing pregnancy and may lower a women’s overall risk of cancer by providing protection against other types of cancer
There are nonhormonal methods of birth control that are also good options
Women can do things to help lower their risk of breast cancer, like breastfeeding, getting more exercise, and limiting alcohol intake
Practice Advisory: Hormonal Contraception and Risk of Breast Cancer
Drug interactions between non-rifamycin antibiotics and hormonal contraception: a systematic review
Use of long-acting reversible contraceptive (LARC) methods, both intrauterine devices and subdermal contraceptive implants, has increased dramatically in the past ten years. Although the risk of complications is low, as use increases the absolute number of complications will increase.
LARCs are highly effective contraceptives with a low risk of complications. Those mentioned above should be discussed with patients as part of informed consent.
ICD-10 codes:
ACOG Committee Opinion 672: Clinical challenges of long-acting reversible contraceptive methods
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