The Pill Won't Kill Us: Study Shows Oral Contraceptives Decrease Risk Of Death

Good news: according to a big new study, using birth control pills is “not associated with increased long-term risk of death.” The bad news: it’s still really hard to get new contraceptives to market.

The study was conducted on 46,000 UK women over forty years, yielding what the EurekAlert release calls “more than a million woman-years of observation.” All these woman-years showed that women who had been on the Pill at any point “had a significantly lower rate of death from any cause, including heart disease and all cancers,” than those who had never used it. A few caveats: women under 45 who currently take or have recently taken birth control pills have a slightly higher death risk, but researchers say the risk disappears after about 10 years and is outweighed by benefits later on (ie. at some point having taken birth control becomes protective). Researchers also caution that the study, which started in 1968, looked at older types of birth control pill, and newer versions may have new risks. Finally — and bizarrely — Pill users appear to be at a higher risk of violent or accidental death than those who have never taken birth control. The researchers note that theirs is not the first study to find this effect, but they can’t explain it. Perhaps women who use the Pill are simply more likely to be in relationships with men, and thus more vulnerable to domestic violence?

Caveats aside, the researchers say, “oral contraception is not significantly associated with an increased long-term risk of death … indeed a net benefit was apparent.” They add that “Many women, especially those who used the first generation of oral contraceptives many years ago, are likely to be reassured by our results.” Especially given the widely publicized risks of hormone replacement therapy, it is a relief to know that at least older contraceptives are relatively safe. What’s not a relief: how difficult it still is to gain support for birth control innovations.

Slate‘s Jennifer Austin writes that birth control pioneers fail to get the respect they deserve. Gregory Pincus, inventor of the Pill, “was a vilified maverick, a so-called, ‘Dr. Frankenstein’ who spent most of his career defending the academics of both in vitro fertilization and contraception alike.” Furthermore, those women hoping for a male pill so that dudes can share the worry over “long-term risk of death” may be SOL. Austin writes,

There is relatively no profitability in contraceptive evolution. Development is governed first by sales potential and only later by public health need. This means that all the pills, patches, and implantable rods that have been created specifically for use by men probably won’t reach the market anytime soon. It’s not because they don’t work. The Population Council has a slew of projects under way, using a synthetic steroid called MENT, that promise to temporarily reduce sperm count. It’s because Big Pharma thinks they won’t sell, or so one theory goes. Without a new blockbuster, there’s little opportunity to gain prominence.

She adds that, “The low profile of contraceptive pioneers also has something to do with opposition to a field of science that ‘promotes promiscuity.'” Anti-contraceptive, abstinence-only forces have sometimes argued — somewhat disingenuously — that the Pill is harmful to women. The recent long-term study may remove some ammunition from this argument — though anti-Pill crusaders may simply claim that oral contraceptives somehow pervert relationships and cause violence. In general, the Pill is far more controversial than it deserves to be. Ultimately it’s a medication, with risks and benefits like any other — and those risks may not be as severe as some have thought.

Contraceptive Pill Not Associated With Increased Long-Term Risk Of Death [EurekAlert]
Birth Control Pill Poses No Added Health Risk [Reuters]
The Contraception Pioneers [Slate]
Mortality Among Contraceptive Pill Users: Cohort Evidence From Royal College Of General Practitioners’ Oral Contraception Study [BMJ]