Which statement about hepatocellular adenoma risk and contraception is true?

Which statement about hepatocellular adenoma risk and contraception is true?

• A. Oral contraceptives are associated with growth of hepatocellular adenoma, and this risk is thought to extend to other types of hormonal contraceptives
• B. Hepatocellular adenoma risk is not influenced by hormonal contraception
• C. Progestin-only methods carry a greater risk than estrogen-containing methods
• D. Intrauterine devices increase the risk

Answer: (A)

Estrogen exposure from hormonal contraception can promote the growth of hepatocellular adenomas. Combined estrogen-containing oral contraceptives are the classic factor linked to both the development and enlargement of these lesions, and the effect is thought to extend to other systemic hormonal methods because they also provide estrogen exposure. In practice, stopping estrogen-containing contraception often leads to stabilization or regression of the adenoma over time. Progestin-only methods have a less clear or weaker association with adenoma growth, and intrauterine devices (including levonorgestrel-releasing or copper IUDs) do not meaningfully increase this risk. Therefore, the statement that oral contraceptives are associated with growth and that this risk extends to other hormonal contraceptives best aligns with what’s observed clinically.

Estrogen exposure from hormonal contraception can promote the growth of hepatocellular adenomas. Combined estrogen-containing oral contraceptives are the classic factor linked to both the development and enlargement of these lesions, and the effect is thought to extend to other systemic hormonal methods because they also provide estrogen exposure. In practice, stopping estrogen-containing contraception often leads to stabilization or regression of the adenoma over time. Progestin-only methods have a less clear or weaker association with adenoma growth, and intrauterine devices (including levonorgestrel-releasing or copper IUDs) do not meaningfully increase this risk. Therefore, the statement that oral contraceptives are associated with growth and that this risk extends to other hormonal contraceptives best aligns with what’s observed clinically.