Oral Contraceptives: Risks and Benefits
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. But, as with any medicine, there are both risks and benefits.
What Are the Risks of Taking the Pill?
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.
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, though, may cause "good" cholesterol to lower and "bad" cholestorol to rise. But, for most women, these changes in blood levels are not strong enough to have a poor effect on your health.
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 being overweight, 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.
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 (eg, family history of cardiovascular disease, ]]>high cholesterol]]>, 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.
Taking birth control pills for many years may increase the risk of certain types of cancer, like ]]>cervical cancer]]> and liver 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. It is important to remember that there are many other risk factors for cancer. If you are at high risk for breast cancer (eg, 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?
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 ]]>endometrial cancer]]>. 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 ]]>colorectal cancer]]>.
Taking birth control pills may reduce your risk of:
- Heavy bleeding, irregular periods, painful periods, and menstrual cramps
- ]]>Ectopic pregnancy]]> (a pregnancy that occurs outside the uterus, particularly in the fallopian tubes)
- ]]> Iron-deficiency anemia]]>
- Unwanted hair growth
- Pelvic pain due to ]]>endometriosis]]>
- ]]>Pelvic inflammatory disease]]>
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]]>.
American Congress of Obstetricians and Gynecologists
Planned Parenthood Federation of America
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
American Heart Association. High blood pressure in women. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=2123. Updated November 2, 2009. Accessed June 8, 2010.
Burkman R. Oral contraceptives: Current status. Clinical Obstetrics and Gynecology. 2001;44(1):62-72.
Burkman R, Schlesselman JJ, Zieman M. Safety concerns and health benefits associated with oral contraception. Am J Obstet and Gynecol. 2004;190:S5-S22.
DynaMed Editorial Team. Breast cancer (female). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 29, 2010. Accessed June 8, 2010.
DynaMed Editorial Team. Hypertension. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 29, 2010. Accessed June 8, 2010.
DynaMed Editorial Team. Osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 3, 2010. Accessed June 8, 2010.
Fact sheet: Oral contraceptives and cancer risk. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Risk/oral-contraceptives.
Family Doctor. Perimenopausal women and the use of very low-dose birth control pills. Family Doctor.org website. Available at: http://familydoctor.org/online/famdocen/home/women/reproductive/menopause/326.html. Updated February 2008. Accessed June 8, 2010.
IARC monographs programme finds combined estrogen-progestogen contraceptives and menopausal therapy are carcinogenic to humans. International Agency for Research on Cancer; July 29, 2005. Available at: http://www.iarc.fr/ENG/Press_Releases/pr167a.html#Group1 .
Jensen JT, Speroff L. Health benefits of oral contraceptives. Obstet and Gynecol Clinics of North Am. 2000;27(4): 705-721.
Mayo Clinic. Birth control. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/birth-control-pill/WO00098/NSECTIONGROUP=2. Updated May 22, 2009. Accessed June 8, 2010.
National Cancer Institute. Oral contraceptives and cancer risk: questions and answers. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Risk/oral-contraceptives. Update May 4, 2006. Accessed June 8, 2010.
Norton A. Birth control pills may lower colon cancer risk. Reuters website. Available at: http://www.reuters.com/article/idUSKIM05941720080220. Published February 20, 2008. Accessed June 8, 2010.
Schneider HP, Mueck AO, Kuhl H. IARC monographs program on carcinogenicity of combined hormonal contraceptives and menopausal therapy. Climacteric. Dec 2005;8(4):311-316.
The Society of Obstetricians and Gynaecologists of Canada. SOGC position statement: the birth control pill and cancer. The Society of Obstetricians and Gynaecologists of Canada website. Available at: http://www.sogc.org/media/guidelines-oc_e.asp. Updated February 19, 2008. Accessed June 8, 2010.
Victory R, et al. Adverse cardiovascular disease outcomes are reduced in women with a history of oral contraceptive use: Results from the Women’s Health Initiative Database [abstract]. Fertility and Sterility. 2004;82(2):0-130.
Women's Health. The dangers of nicotine and birth control pills. Women's Health website. Available at: http://www.womens-health.co.uk/nicotine-and-birth-control-pills.html. Accessed June 8, 2010.
4/9/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance: 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;318:96-100.
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 Mar 11;340:c927.
Last reviewed June 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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