After the Pill caused her not one but two liver tumors, Makenzie Hammond chose to speak up and speak out about her experience and to encourage women to quit hormonal birth control so they can “be the CEOs of their bodies.” According to Newsweek, the 30-year-old Californian took to TikTok to share her story and opined “hormonal birth control is gonna be our generation’s smoking,” referencing the evolution of knowledge about the health risks of smoking. Smoking’s long-term health effects in particular were originally unknown and then downplayed to the general public before becoming widely acknowledged.
Liver tumors are a known, rare side effect of hormonal contraception
Hammond visited her doctor for what she thought were “stomach problems” that had lasted for months. But in January of 2023 an MRI showed that she had two benign liver tumors, also known as hepatic adenomas. In her TikTok video, she stated, “If you look in your birth control packet right now, it will literally tell you that after eight years of use, the risk for liver tumors goes up significantly.” Hammond herself took birth control pills for a total of 13 years.
Her doctors pointed the finger at her contraceptive pill as the culprit. While generally rare, when these tumors do occur they’re often related to oral contraceptive use, according to healthcare technology and education organization StatPearls [1]. Hammond’s post launched a viral conversation. Her video has now been viewed by over 1.2 million users, leaving many women to ponder their own choices when it comes to contraception.
Are liver tumors caused by birth control cancerous?
A common question that arises about liver tumors caused by birth control is whether the tumors are typically benign or cancerous. Dr. Shoshana Ungerleider, a board-certified internal medicine physician and the Host of TED Health told Newsweek, “Hepatic adenomas are rare, benign liver tumors that primarily occur in women of childbearing age.” She noted that women with glycogen storage disease or obesity are more likely to develop them.
Just because a tumor is benign doesn’t mean it won’t cause problems, though. Hammond went to her doctor because she was having significant abdominal pain, especially when she ate. This makes sense given her tumors are “on my stomach” and the bigger one is 5.8 cm, or more than 2.25 inches.
What are the treatment options?
After her diagnosis, Hammond stopped taking birth control since continuing to take it would likely only increase the tumors’ size. She also had a biopsy to confirm that the tumors were not cancerous. The treatment plan right now is just ‘watchful waiting,’ meaning that she will continue to have imaging scans done every few months to make sure that the tumors aren’t growing and, hopefully, gradually shrink. Surgery to remove the tumors could be in her future.
What else could go wrong?
In her video, Hammond talked about the unlikely but possible complication of internal bleeding due to tumor rupture. There’s also a remote possibility of a birth control-caused liver tumor becoming cancerous [2].
How could birth control cause a liver tumor?
Ungerleider called the process of hepatic adenoma development due to birth control “complex” and noted that the estrogen in the Pill is likely the main cause. She explained, “The liver plays a key role in hormone metabolism, and increased exposure to estrogen or similar substances over a prolonged period can alter normal liver cell activity. This hormonal alteration can trigger increased cellular proliferation and abnormal growth patterns, eventually leading to the formation of an adenoma.”
How often does birth control cause liver tumors?
In the video, Hammond cited the package insert for her birth control as saying that just 3.3 cases of liver tumor will occur per 100,000 users. The 1,300 other women in an online Facebook support group for birth control-caused liver tumors suggest that the actual number may be much higher. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury reports,“in population-based surveys, the risk of developing hepatic adenomas on OCCs (oral contraceptives) is estimated to be 0.5% per year” [2].
The percentage may seem small, so let’s put it into perspective with some approximations. According to the CDC, women aged 20-29 are most likely to be on the Pill (19.5%) when compared to women aged 15-19 (16.5%), 30-39 (11%), or 40-49 (5.1%). Given 65,080,433 women of reproductive age in the US as of 2021, and 33% of them between 20 and 29 years of age, that’s roughly 21 million young women. At a rate of 1 liver tumor per 200 women (which is 0.5%), 107,000 contraceptive users aged 20 to 29 may develop a liver tumor each year! This number translates to 215 liver tumors per 100,000 users, which is exponentially higher than the package insert Hammond referenced estimating 3.3 liver tumors per 100,000 oral contraceptive users. What’s more, per Dr. Ungerleider, the risk of developing hepatic adenomas increases with duration of oral contraceptive use.
Fertility Awareness is a safe family planning option
Hammond is now a fertility awareness advocate and recommends other women make the switch. She said, “This is your sign. Talk to your doctor. Get off of your hormonal birth control. You don’t need to be on it, you can track your cycle naturally. I track mine with my Oura ring.”
She closed, “You heard it here first. I’m calling it that birth control is gonna be our generation’s smoking. And we’re gonna look back in 10, 20, 30 years and nobody’s going to be taking it anymore, because it’s bad for us. Be the CEO of your own body. Do the research about what’s the best option for you.”
This article was updated on January 12, 2024 to more accurately reflect the number of liver tumors that oral contraceptive users may experience in a given year.
References:
[1] Shreenath AP, Kahloon A. Hepatic Adenoma. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513264/ [2] LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Estrogens and Oral Contraceptives. [Updated 2020 May 28]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548539/Additional Reading:
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