There’s no surefire way to prevent a diagnosis of ovarian cancer in your lifetime. That’s because right now there’s no good screening method for the disease, and any early symptoms like bloating are easy to confuse with those of other conditions.
But that doesn’t mean you don’t have any control. While you can’t change the two main risk factors for ovarian cancer–being a woman and age (the average age for an ovarian cancer diagnosis is 62)–there are plenty of other risk factors you can affect.
If you have ovarian cancer risk factors, don’t freak out. They don’t mean you’ll definitely end up with ovarian cancer. But it’s worth taking steps where you can to lower that risk. Here are some factors linked with a reduction in ovarian cancer risk.
Research has shown that women who take birth control pills have lower odds of developing ovarian cancer. That protection increases the longer you take the pills and can last for as long as 35 years. What’s more, the reduced risk may kick in as early as three to six months after starting.
“There’s a hypothesis that the more ovulation somebody has in their lifetime, the higher their risk of having ovarian cancer,” says David Kushner, MD, professor of gynecologic oncology at the University of Wisconsin School of Medicine and Public Health. “Using birth control keeps you from ovulating and has been shown to decrease ovarian cancer risk by [up to] 50%.” (For the same reason, starting your period early and going through menopause late can increase your ovarian cancer risk.)
But there are also risks linked to taking birth control pills, including heart attacks and blood clots. “It’s not recommended that everyone take oral contraceptives to reduce [ovarian cancer] risk, but it’s a good side benefit,” says Shannon Westin, MD, associate professor of gynecologic oncology and reproductive medicine at MD Anderson Cancer Center in Houston.
Obesity is a risk factor for ovarian cancer, especially if you are or were obese in early adulthood. People who are obese may also be more likely to die of ovarian cancer.
“Obesity has been demonstrated as an increasing risk factor for many cancers, and there’s a link between obesity and ovarian cancer,” says Dr. Westin. “That is something that can be mitigated.” Yet another reason to lose weight if you need to or maintain a healthy weight.
It’s a good idea in general to load up on vegetables, along with fruits and other plant-based foods. Save red and processed meats for special occasions.
“There are multiple studies showing that [a low-fat diet] can be beneficial” in reducing ovarian cancer risk, says Adi Davidov, MD, director of gynecology at Staten Island University Hospital. “We definitely recommend that.”
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Pregnancy and breastfeeding
Pregnancy and breastfeeding are linked to a lower risk of ovarian cancer. This comes back to how many times you ovulate in your lifetime.
“When you’re pregnant, you don’t ovulate,” says Dr. Kushner. You are also less likely to ovulate when you breastfeed.
The age at which you get pregnant also matters. Research shows that women who deliver babies before they are 26 have an even lower risk of ovarian cancer than women who wait. The more pregnancies, the less risk.
That’s not to say that you will get ovarian cancer if you decide not to have children or don’t breastfeed. (Nor should avoiding ovarian cancer be your main motivator in getting pregnant.) A woman’s overall risk for getting ovarian cancer sometime in her life is about 1 in 78, according to the American Cancer Society (ACS).
Tubal ligation (closing the fallopian tubes) and hysterectomy (removal of the uterus and possibly the cervix) are surgeries sometimes done to treat other health conditions or to eliminate your chance of getting pregnant, among other reasons.
Both reduce ovarian cancer risk, but “we’re still trying to understand why,” says Dr. Westin.
Of course, these surgeries are not to be taken lightly and can carry major risk. Like with birth control pills, lower risk of ovarian cancer isn’t usually the only factor that goes into deciding to have one of these procedures (unless you’re at high risk), but it can be a side benefit.
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Removing the ovaries and fallopian tubes
If you are at high risk of ovarian cancer, preventive or prophylactic surgery may be an option for you. Many women who have a family history or personal history of ovarian cancer or a gene mutation that raises their risk have both their ovaries and fallopian tubes taken out, a procedure called a bilateral salpingo-oophorectomy.
If you have a strong family history of ovarian or other hereditary cancers or a known gene mutation, you may be a good candidate for genetic counseling. Mutations in the BRCA1 and BRCA2 genes increase your risk of both ovarian and breast cancer, but other genetic mutations can increase ovarian cancer risk as well.
A genetic counselor can talk to you about ways, including surgery, to mitigate your risk.
The jury is still out on whether fertility drugs really do raise your risk of ovarian cancer, but there is some evidence that one in particular, clomiphene citrate (sold under the brand name Clomid and others), may do just that. Physicians haven’t stopped using it, but they have modified how they do so.
“This has prompted physicians over the years to avoid giving it for over six months because of the risk of ovarian cancer,” says Dr. Davidov. “Typically if a woman is having difficulty getting pregnant and we find they’re not ovulating, we will try Clomid for a couple of months.” If that doesn’t work, they’ll usually move on to another option, he says.
No one is sure why this might be; it’s possible women having a hard time getting pregnant may be at a higher risk of ovarian cancer even if they don’t use fertility drugs, according to the ACS.
Taking hormone therapy after menopause may increase your risk of ovarian cancer, but there’s no definitive proof.
Usually used to reduce hot flashes and other symptoms of The Big Change, hormone therapy, like fertility drugs, remains somewhat misunderstood. Some experts say hormone therapy in the form of estrogen alone may increase ovarian cancer risk, while others say estrogen plus progesterone is problematic, says Dr. Westin. Still others believe there’s no risk at all.
Dr. Davidov points out that birth control pills–which are similar to hormone therapy–seem to protect against ovarian cancer.