• Oral Contraceptives: Risks and Benefits

    Image for oral contraceptives Since first introduced in the 1960s, the birth control pill ("the pill") has been a popular and extremely effective form of contraception. The pill is easy to use and, when taken correctly, it is 95% to 99.9% successful at preventing pregnancy. However as with any medication, there are both risks and benefits.

    What Are the Risks of Taking the Pill?

    Unintended Pregnancy

    While birth control pills are highly reliable in preventing pregnancy, there is the possibility that you could become pregnant. This is especially true if you miss a dose or do not take the pills regularly. Excess weight or obesity may also increase your risk of pregancy. The excess weight may affect how well the pills work in your body.

    Blood Clots

    Oral contraceptive pills can increase your risk of developing blood clots in the veins in your legs. These can become life threatening if the blood clots leave your legs and travel into you lungs. The risk of blood clots is increased more in people who smoke.

    Cholesterol Levels

    There are different kinds of birth control pills. Some are combination pills, with estrogen and progestin, while others are "mini-pills" with just progestin. Estrogen may affect triglyceride levels and total cholesterol levels—increasing HDL "good" cholesterol and decreasing LDL "bad" cholesterol. Progestin may cause "good" cholesterol to lower and "bad" cholestorol to rise. For most women, these changes in blood levels are not strong enough to have a poor effect on your health.

    Migraine Headaches

    Certain oral contraceptives may trigger a migraine, especially those containing estrogen. If you have migraines, talk to your doctor about your contraceptive options.

    High Blood Pressure

    Taking birth control pills may increase the risk of high blood pressure. This risk may be greater if you have other conditions, like obesity, having a family history of high blood pressure, or smoking. If you take birth control pills, your doctor will check your blood pressure. If you already have high blood pressure, talk to your doctor about other contraceptive options.

    Cardiovascular Disease

    Women aged 35 or older who smoke heavily and take birth control pills have an increased risk of having a heart attack or stroke. You may have an even greater risk if you have other risk factors (like a family history of cardiovascular disease, high cholesterol, or high blood pressure). If you want to take birth control pills, you should first quit smoking since smoking increases your chance of developing many other health problems.

    Cancer

    Taking birth control pills for many years may increase the risk of certain types of cancer, like cervical cancer. Researchers are still investigating the link between birth control pills and breast cancer. Some studies have found that there is an increased risk, while others studies have come to the opposite conclusion. According to the National Cancer Institute, there appears to be a slight increase in risk, but the risk level goes back to normal after 10 years of stopping birth control pills. It is important to remember that there are many other risk factors for cancer. If you are at high risk for breast cancer (like having certain types of genes or a family history) or other types of cancer, talk to you doctor about the best contraceptive for you.

    What Are the Benefits of Taking the Pill?

    Cancer

    While the pill may increase the risk of some types of cancer, it can also decrease the risk of other types of cancer, like ovarian and uterine cancers. Studies have found that the more years a woman takes the pill, the better her protection. In addition, researchers are investigating whether birth control pills decrease the chance of developing colon or rectal cancers.

    Other Benefits

    Taking birth control pills may reduce your risk of:
    There are many different types of birth control pills on the market. You and your doctor can decide which kind is best for you, or if a different contraceptive option would be a better choice. Just keep in mind that the pill does not protect against HIV and other sexually transmitted diseases (STDs).

    RESOURCES

    Planned Parenthood Federation of America http://www.plannedparenthood.org

    The American Congress of Obstetricians and Gynecologists http://www.acog.org

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    Birth control. Mayo Clinic website. Available at: http://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/birth-control-pill/art-20045136?pg=2. Updated May 21, 2013. Accessed February 24, 2016.

    Burkman R, Schlesselman JJ, Zieman M. Safety concerns and health benefits associated with oral contraception. Am J Obstet and Gynecol. 2004;190(4 Suppl):S5-S22.

    High blood pressure and women. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/High-Blood-Pressure-and-Women%5FUCM%5F301867%5FArticle.jsp. Updated June 6, 2012. Accessed February 24, 2016.

    Migraine in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 25, 2016. Accessed April 5, 2016.

    Oral contraceptives. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 21, 2015. Accessed February 24, 2016.

    Oral contraceptives and cancer risk. National Cancer Institute website. Available at: http://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet. Updated March 21, 2012. Accessed February 24, 2016.

    Risk factors for breast cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 17, 2015. Accessed February 24, 2016.

    Risk factors for hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 3, 2014. Accessed February 24, 2016.

    Schneider HP, Mueck AO, Kuhl H. IARC monographs program on carcinogenicity of combined hormonal contraceptives and menopausal therapy. Climacteric.Dec;8(4):311-316.

    4/9/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Beral V, Hermon C, Kay C, Hannaford P, Darby S, Reeves G. Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46,000 women from Royal College of General Practitioners' oral contraception study. BMJ. 1999;318(7176):96-100. Hannaford PC, Iversen L, Macfarlane TV, Elliott AM, Angus V, Lee AJ. Mortality among contraceptive pill users: cohort evidence from Royal College of General Practitioners' Oral Contraception Study. BMJ. 2010;340:c927.

    12/3/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what. Lopez L, Grimes D, Chen-Mok M, Westhoff C, Edelman A, Helmerhorst F. Hormonal contraceptives for contraception in overweight or obese women. Cochrane Database Syst Rev. 2010;(7):CD008452.

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