Apparently Tuesday was #ThxBirthControl Day. Some would have you believe that birth control, primarily oral contraceptives, are a wonder drug that saves hundreds of thousands of lives a year. Others called it ” poison,” saying that it triples the risk of suicide.
As with most things, the truth lies somewhere in the middle.
In the most literal way, birth control does save the lives of the unborn. Unless we’re debating the technical functions of a specific sort of hormonal intrauterine device which may allow an egg to be fertilized before the uterus rejects its implantation, forms of birth control such as oral contraceptives, the pill, the patch, Depo-Provera, and copper IUDs prevent fertilization, period. The mass proliferation of birth control, in tandem with better health education, has been a significant factor in reducing the nation’s abortion rate to its lowest levels since before Roe v. Wade.
But what about for women themselves? Is it really a corrosive drug making women, as Milo Yiannopoulos once famously said, ” unattractive and crazy“? The short answer is no.
The longer answer, predictably, involves a decent amount of science.
First, let’s look at the headlines that birth control triples the risk of suicide and makes even more women depressed. There is a statistically significant correlation between the use of hormonal birth control and suicide and depression. However, in terms of absolute risk, the odds are extremely minor. In the single Danish study that made the rounds last year, a sample of half a million women demonstrated that recent or current birth control users had a 1.97 higher risk of attempting suicide. The was a 3.08 higher risk of successful suicide, a far less useful figure because really all it depicts is competency, not crippling mental illness.
However, the study notes that double-risk factor peaks within the first year then plummets, mainly because the subset of women not compatible with birth control out-select themselves while the overwhelming majority who have limited-to-no side effects remain on it.
Furthermore, the attempted suicide rates for every demographic and the overall average was well under a half of 1 percent across the entire sample.
Similarly, while the relative risk of developing depression was far higher for birth control users than for nonusers, the absolute risk is just 0.5 percent higher. These statistics ignore the obvious positive emotional benefits for women who want to wait or forgo having children, which are much harder to quantify.
Most of the cancer scare or laudatory articles rely on ignoring relative risk factors for exactly this purpose.
People trying to scare you mention that birth control increases your risk of breast and cervical cancer, and those trying to advertise birth control note that it reduces your risk of endometrial, colon, and ovarian cancers. All are true, and if you look at the figures, they tend to cancel each other out.
For example, the relative risk for developing breast cancer for a woman using birth control is 20 percent higher than that of a nonuser. As the Upshot at the New York Times notes, that means a single extra birth control user might get breast cancer for every 7,690 birth control users — and that’s for women overall. Most doctors do not recommend oral contraceptives for women over 35, and the risk for those younger would be an extra breast cancer case for every 50,000 birth control users.
All of this ignores the 14 percent of oral contraceptive users who are on the pill purely for other health purposes, such as treating crippling menorrhagia or period-induced migraines.
But most importantly, all of these risk factors, from cancer to depression, are overwhelmingly linked to obesity and smoking far more than any kind of birth control. Voluntary lifestyle factors cause 42 percent of all cancer, with nearly 75 percent of that portion attributed to cigarette use, body weight, and physical activity.
Life rarely deals in absolutes, and modern medicine even less so. While almost nothing comes with zero risk, birth control is much like any other medication: one that the user needs to be informed about to make an educated decision and that is overwhelmingly beneficial for large swaths of the population.