Combined oral contraceptives do not increase incidence of macromastia in young women: Research

According to a study published in the October issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons, combined oral contraceptives (COCs) containing both oestrogen and progestin do not contribute to the development of enlarged breasts (macromastia), nor do they increase the risk of breast regrowth in adolescents and young women after breast-reduction surgery (ASPS).

The journal was produced by Wolters Kluwer as part of the Lippincott portfolio. According to a recent study led by ASPS Member Surgeon Brian I. Labow, MD, of Boston Children’s Hospital and Harvard Medical School, and colleagues, using COCs throughout adolescence may be associated with less severe breast growth (hypertrophy).

Doctors are advised to look into COCs for young females suffering from macromastia.

Breast reduction surgery, also known as reduction mammaplasty, is a successful treatment for teenagers and women suffering from macromastia that alleviates discomfort and psychological concerns. Combination oral contraceptives are the most prevalent kind of hormonal contraception (HCs). In addition to their contraceptive advantages, COCs are used to treat a range of disorders in teenagers, including acne, menstrual irregularities, endometriosis, and polycystic ovary syndrome.

“Despite COCs’ beneficial benefits, many patients, parents, and doctors are concerned that their use would exacerbate breast hypertrophy in teens,” write Dr. Labow and colleagues.

They add, “The internet is filled with anecdotal experiences and lay publications stating that COC usage in teens and young women may result in breast development.” “The internet is filled with anecdotal evidence and lay publications claiming that COC usage in teenagers and young women might cause breast development.”

What effect do COCs have on breast augmentation and symptoms in young women and girls? The research included 378 individuals ranging in age from 12 to 21 years who were undergoing reduction mammaplasty at Boston Children’s Hospital. The severity of macromastia in patients who employed COCs and other HCs, as well as breast regrowth in the first year following reduction mammaplasty, were compared.

The results were compared to a control group of 378 female patients of the same age. The average age in both groups was roughly 18 years. Patients with macromastia were more likely to be overweight or obese, supporting the notion that obesity is a risk factor for macromastia.

Overall, patients with macromastia utilised 38% less HCs than the control group: 38% versus 65%. Women using HCs for macromastia were more likely to be prescribed COCs: 83% versus 53%. The oestrogen and progestin doses were comparable among groups.

In individuals with macromastia, using COCs did not appear to lessen the severity of breast growth.

The median amount of breast tissue excised during reduction mammaplasty was comparable across groups – in fact, somewhat less in women who used COCs versus no HC usage. Pain and other macromastia symptoms (such as breast skin irritation, difficulty exercising, or difficulty finding clothing that fit) were similarly comparable between groups.

At a median follow-up of roughly 2 years following reduction mammaplasty, there was no significant difference in the rate of breast regrowth between patients who used COCs and those who did not use COCs. In all, around 5% of people reported postoperative breast regrowth. Breast gland regrowth, rather than weight gain, was responsible for around half of the instances.

Women who took COCs after a reduction mammaplasty showed no increased risk of breast regrowth.

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According to Dr. Labow and colleagues, the findings refute “pervasive anecdotal allegations” that COCs throughout adolescence may increase the risk of macromastia. “While further research is needed,” they conclude, “providers are recommended to consider COCs when prescribing HCs for their patients with macromastia when necessary and appropriate.”

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