Birth Control Pill May Triple Risk Of Crohn's Disease In Women With Family History Of The Condition
With over 60% of the global population on some form of hormonal birth control, researchers have naturally been looking into their potential side effects.
Researcher Dr. Hamad Khalili from Harvard University looked to investigate the association between the use of the oral contraceptives and the risk of Crohn's disease (CD) and ulcerative colitis (UC). The study on the link between the birth control pill and Crohn’s disease has led the team of doctors to suggest that women with an already genetic predisposition to the chronic gastrointestinal disease may be three times more likely to develop the condition if they have used "the pill" for at least five years.
The Study
The study released in the BMJ was carried out on 117,375 US women enrolled since 1976 in the Nurses Health Study I (NHS I) and 115 077 women enrolled since 1989 in the Nurses' Health Study II (NHS II) with no prior history of UC or CD. These women had provided information every 2 years, on age at menarche (first menstrual period), oral contraceptive use, parity (any children), menopause status and other risk factors. The diagnoses of CD and UC were confirmed by review of medical records.
“If you took oral contraceptives for more than five years you have a three-fold increased risk of the disease.”
The Results
Results showed that there was no link between oral birth control and increased risk for developing ulcerative colitis. Unfortunately, the same could not be said for Crohn’s disease. The study found that if you took oral contraceptives for more than five years, you have a three-fold increased risk of Crohn’s disease. Dr. Khalili believes that Crohn’s is not caused by oral contraceptive use by itself, it’s a combination of oral contraceptive use among individuals with a strong genetic predisposition to Crohn’s.
Estrogen is thought to both affect the colon’s permeability and may affect gut immunity. Khalili also believes that excess amounts of the hormone can affect the “healthy” bacteria residing in our gut. Although the “morning-after pill” emergency contraceptive was not included in the study, due to the similar composition, Khalili suggested that women who use this drug may be at a similar risk, since it has even stronger doses of hormones than those found in the pill. Although there seems to be a link between the birth control pill and gastrointestinal problems, the study was adamant that one did not definitely cause the other.
Could the rise in women experiencing Crohn’s be due to the OCP?
Crohn’s disease is a serious, incurable, and largely debilitating condition and the number of women experiencing this condition has inexplicably risen two- or three-fold in the past 50 years. Khalili’s study cannot explain the overall rise in the number of Crohn’s patients, but his findings will hopefully be of use to women who have a genetic predisposition to gastrointestinal conditions.
Take home message
The birth control pill is one of the most widely used form of contraceptives in the world but there are many more forms of birth control available and women should be well informed of the risks associated with each before deciding which is best for them.