Are birth control pills the same as hormone replacement therapy?

Both birth control pills and hormone replacement therapy often consist of a combination of the hormones estrogen and progesterone. You may, therefore, wonder if the two treatments affect the body in the same way. The simple answer is “no,” but the more complicated answer is that researchers are not yet entirely sure.

A number of factors vary between the two types of treatment. Birth control pills are administered at a high enough dosage to prevent ovulation and pregnancy. Hormone replacement therapy strives to return postmenopausal women’s hormone levels to what they were before menopause. The hormone formulation and dosage in each treatment can vary.

Studies suggest that hormone replacement therapy with both estrogen and progesterone may increase a woman’s risk for breast cancer, heart attack and stroke, while estrogen-only therapies may have no affect on heart health but can increase stroke risk. Women who take birth control pills are at a greater risk of blood clots, which can cause heart attack and stroke, but no link has been proven to breast cancer. The risk of blood clots and heart attack with birth control pills is higher in women over 35 and in those who also smoke.

If you are a woman who is considering either treatment, discuss your risk factors, including family history, age and known medical conditions, as well as the possible benefits and drawbacks with your healthcare provider.