Ditch The Myth: The Truth About The Pill, From Cancer Risks to TikTok Lies

There is an ugly trend on social platforms where dramatic anecdotes about the pill travel faster than careful science. In five minutes on TikTok, you might see a clip claiming that the pill “causes cancer,” “ruins fertility,” or “changes your personality.” Those short clips are optimized for emotion and shock, not nuance. This article cuts through the noise with a calm, evidence-based look at what the science actually says — including the new cohort study from JAMA Oncology (Oct 30, 2025) and the foundational 2017 Danish research — so you can make informed decisions about contraception, not fearful ones.

Your Body on Hormones: A Simple Guide to How Birth Control Actually Works

Hormonal contraceptives generally use synthetic versions of estrogen and progestin in combined methods, or progestin alone in progestin-only pills, implants, injections, or hormonal IUDs. These hormones prevent pregnancy by stopping ovulation, thickening cervical mucus to block sperm, and changing the lining of the uterus so it becomes less receptive to implantation. These same mechanisms also explain why hormonal contraception can affect menstrual bleeding, acne, or mood. Different formulations exist because people respond differently — and because risk profiles vary.

From Fear to Fact: Tracing the Origins of the “Pill Panic”

Worry about hormonal contraception isn’t new. For decades, researchers have studied whether taking synthetic sex hormones affects cancer risk. Some large studies found a small increase in breast cancer risk among current or recent users. These were relative risks, and in young populations — where breast cancer is rare — they translate to very small absolute risk increases.

The 2017 Danish cohort study in the New England Journal of Medicine followed 1.8 million women and identified 11,517 breast cancer cases, finding a relative risk of 1.20 (a 20% increase), which equates to roughly 13 extra cases per 100,000 person-years — around 1 additional case per 7,690 woman-years of use.

The new Swedish nationwide cohort published in JAMA Oncology on October 30, 2025, examined more than 2 million women and found that the risk is not the same for all formulations. Some progestin-only methods, such as desogestrel-only pills and etonogestrel implants, showed higher relative risks than levonorgestrel-based methods.

The Key Takeaway from the New 2025 Study (That TikTok Won’t Tell You)

The Swedish analysis found a hazard ratio of 1.24 associated with ever-use of hormonal contraception, meaning a 24% relative increase. Progestin-only methods showed an HR of 1.21, slightly higher than combined pills. The highest-risk formulations included desogestrel-only pills, desogestrel-containing combined pills, and etonogestrel implants. The lowest-risk options — including the 52 mg levonorgestrel IUD, drospirenone-containing combined pills, the medroxyprogesterone injection, and the etonogestrel vaginal ring — showed no statistically significant increase in breast cancer risk.

In practical terms, if you are concerned about breast cancer risk, clinicians can prescribe lower-risk formulations such as levonorgestrel IUDs or drospirenone-based pills without sacrificing contraceptive efficacy.

Absolute Risk in Plain English (Because Relative Risk Scares People)

The Swedish study found roughly 1 additional breast cancer case per 7,752 woman-years of hormonal contraceptive use. The Danish study reported approximately 1 per 7,690. For women under age 35, the Danish researchers estimated around 1 extra case per 50,000 woman-years of use. For perspective, the risk of dying from pregnancy or childbirth in the United States is higher than the added breast cancer risk from hormonal contraception.

Other Myths Debunked

Post-pill infertility: Fertility returns quickly for most users of combined pills, patches, rings, and most IUDs. A temporary delay is possible with the depot medroxyprogesterone injection, with ovulation typically returning 4–10 months after the last shot.

The pill permanently changes your personality: There is no high-quality evidence supporting this claim. Some users may notice mild mood changes, but many experience improved well-being due to cycle regulation.

All hormonal birth control is the same: This is false. The 2025 Swedish study clearly demonstrates that different formulations carry different risk profiles.

Bottom Line for 2025

Hormonal contraception carries a small increased breast cancer risk, one that is smaller than many lifestyle-related risks, including alcohol use, obesity, and lack of physical activity. The risk is not uniform across contraceptive methods; some modern formulations, particularly the levonorgestrel IUD and drospirenone-based pills, appear to have negligible or no measurable increase in risk. For most users, the benefits — pregnancy prevention, reduced ovarian and endometrial cancer risk, and improved cycle control — outweigh the risks.

If you have a family history of breast cancer or other risk factors, talk with your clinician about switching to a lower-risk hormonal option or choosing a non-hormonal method such as a copper IUD or barrier contraception.

References

1. Hadizadeh F, et al. Hormonal Contraceptive Formulations and Breast Cancer Risk in Adolescents and Premenopausal Women. JAMA Oncology. 2025 Oct 30. Link
2. Mørch LS, et al. Contemporary Hormonal Contraception and the Risk of Breast Cancer. New England Journal of Medicine. 2017;377:2228–2239. Link
3. ACOG Practice Advisory (reaffirmed Oct 2024). Link

Written for patients, by a physician who actually reads the studies. No fear. Just facts.