Women who use any type of hormonal birth control experience a small but statistically significant increased risk for developing breast cancer, according to a large study published this week. The link between birth control and breast cancer is disappointing to hear for women who use the pill or other hormone-based options as their contraceptive methods of choice. The research does, however, set the stage for an important discussion.

“It’s important that women feel confident and comfortable with their contraceptive choice,” says Chris Zahn, M.D., vice-president for practice activities with the American Congress of Obstetricians and Gynecologists. “Women concerned about the preliminary findings of this study should speak with a trusted women’s health care provider who can help them to make informed decisions that weigh both the risks of pregnancy and the risks associated with hormonal contraception.”

The study followed 1.8 million Danish women for more than a decade. According to the findings published in the New England Journal of Medicine, there is one additional case of breast cancer for every 7,690 women between the ages of 15 and 49 who use hormonal birth contraceptives for a year. On a larger scale, that’s 13 more breast cancer diagnoses for every 100,000 women.

Among the whole population, that amounted to a 20% increased risk for developing breast cancer among women who used hormonal contreception in comparison to women who never used it. Most at risk—with a 38% relative increase over non-users—were women who used hormonal birth control for 10 or more years.

Hormonal birth control options have long been tied to an increased risk for breast cancer, but there was hope that newer options with lower levels or hormones would solve the problem. This new study demonstrates that’s not so, says Dr. Marisa Weiss, an oncologist who founded the website breastcancer.org.

“What they’ve discovered over the decade is that you don’t need a super high dose of hormone in order to stop ovulation and prevent pregnancy, but it still overpowers your own system,” she tells Motherly. “That is not without dangers.”

How to respond to the news

Because the risk for developing breast cancer was shown to increase in correlation to the duration of time a woman used hormonal birth control, the research has different implications for different groups of people.

Specifically, for young women who don’t have other risk factors for breast cancer, it may still be advisable to use hormonal birth control for five years or less due to its role in deceasing the risk for developing other types of cancer. The convenience and efficacy of a pill, IUD, patch or implant is also a significant factor for many.

“These methods offer women critical control over their health, including if and when to become pregnant, reducing risk of cervical cancer, and in some cases aiding with management of chronic conditions like acne or painful periods,” says ACOG vice-president Zahn.

As women age and their family planning needs change, the new study suggests they should seriously consider non-hormonal birth control methods, says Weiss.

She says good non-hormonal options include the Paragard IUD, condoms and diaphragms, as well as more permanent solutions when you feel your family is complete. Younger women who take birth control for reasons such as acne management should also consider speaking with their dermatologists for alternatives.

For everyone, Weiss says a key takeaway is the importance of advocating for your own health. She suggests scheduling an appointment with your doctor and giving them a heads up about what you plan to discuss.

The good news is that there are plenty of birth control options—and the more you know, the better able you are to make the right choice for yourself.