What are the benefits and risks of taking birth control pills?
Medically reviewed on Mar 19, 2018 by L. Anderson, PharmD.
Benefits of the Birth Control Pill
There are many advantages to using the birth control pill as a means of female contraception. The birth control pill has been used safely and successfully since 1960 when it was first approved by the FDA. Today's birth control pills contain lower amounts of hormones and come in many different dosing options to allow women effective and flexible methods of family planning.1,2 Many women are able to take the birth control pill with few or no side effects.
- The birth control pill can result in lighter bleeding and decreased pain during your monthly period.
- Studies have shown the birth control pill leads to lower rates of pelvic inflammatory disease and cancer in the unterus and ovaries.
- Effective birth control leads to less worry and is a very effective form of family planning, allowing women and their partners the ability to select the best time to start a family. The pill has a <1% failure rate (meaning less than 1 out of 100 women unintentionally become pregnant) when used correctly.
- There are a variety of birth control pills available to fit your need. For example, progestin-only versions of the pill exist if you are breast-feeding or unable to use estrogen due to medical reasons.
- Using extended-cycle (i.e., Seasonique, Seasonale) or continuous-cycle (i.e., Lybrel) pills allows a woman to have fewer periods or no periods at all, respectively.
- Some birth control pills can help prevent sudden mood changes during a woman’s cycle due to changing hormone levels.
- Acne or premenstrual dysphoric disorder (PMDD) may improve with some birth control pills.
- The birth control pill can lessen heavy bleeding, pain and severity of endometriosis and fibroid tumors.
- Weight gain is not a common side effect with low dose birth control pills in use today. Many years ago the pill contained higher levels of estrogen which may have caused weight gain. Birth control pills may cause slight fluid retention, but that effect is usually temporary.
- Progestin-only pills may be associated with less nausea, breast pain, weight gain, and mood changes than combination birth control pills. Research has not revealed that the progestin-only pill leads to weight gain, depression or headaches.4
- Many generic versions of the birth control pill are available at a lower cost than brand names and are equally effective. Ask your doctor or pharmacist if you prefer a generic birth control pill.
- It is also possible to completely eliminate periods by taking only the active pills continuously (each day) from certain combination birth control pills and skipping the inactive pills. Ask your healthcare provider if this would be a good option for you and which brands you can use for this option. You may require additional pill packs and your insurance may not pay for more than 12 packs per year, so be sure to check with your insurance, as well.1,2
Risks of the Birth Control Pill
The choice of birth control is individual for each woman. Some women may have medical conditions that prevent them from using birth control pills, while other women may be at higher risk for side effects due to age or smoking status. There are some disadvantages to using the birth control pill, and women should consider these risks and discuss them with their health care provider.
- The birth control pills with estrogen can lead to a higher risk for blood clots, heart attack, and stroke in women who smoke, especially if older than 35 years of age. Combination estrogen and progestin birth control (including the pills, ring or patch), or any other kind of birth control that contains the hormone estrogen, should NOT be used by women who are over 35 years of age and smoke. The progestin only pills (mini pills) can be used if you’re a smoker.
- The birth control pill may be require a monthly cost or copay, and therefore may not be affordable for all women. Generic birth control pills are less expensive, but just as effective.
- Taking a pill every day may be difficult for some people. If you miss a pill, you may need to use another form of birth control (i.e., condom and/or spermicide) during your cycle. If you think you'll have trouble taking a pill every day, an IUD may be a better option for you.
- The birth control pill does not protect against sexually transmitted diseases. Only a condom can protect from sexually transmitted diseases.
- The pill has a <1% failure rate (meaning less than 1 out of 100 women unintentionally become pregnant) if used correctly. However, for women who miss taking their pills, the failure rate goes up to roughly five percent, or 5 out of 100 women become pregnant unintentionally.
- There can be drug interactions that may lower the effectiveness of birth control pills. Be sure to ask your pharmacist about potential drug interactions each time you have a prescription filled.
- Spotting (breakthrough bleeding) may occur (mid-cycle) for the first few months of birth control use as your body adjusts to the changes in hormone levels. Breakthrough bleeding may be worse with extended- or continuous-cycle birth control pills or with progestin-only pills.
- Birth control pills can cause breast pain or vaginal dryness; these side effects may continue with use or subside.
- A progestin called drospirenone is found in some birth control pills such as Yaz, Yasmin, Gianvi, Syeda, Safyral, and Beyaz and is linked to a higher risk for blood clots than other pills control pills. Drospirenone may also raise potassium levels in the blood which may cause heart or health problems. It is important to discuss your health history with your doctor prior to using these birth control pills.
- After stopping the pill, it may take several months or longer to begin ovulating again if pregnancy is desired.
- The birth control pill requires a prescription from a healthcare provider. While this may seem inconvenient, it is important to have a regular checkup with your doctor when using the birth control pill.1,2
Warnings for Birth Control Pill Use
Birth control pills should NOT be used by women who have a history of:
- breast cancer
- endometrial cancer
- unexplained vaginal bleeding
- liver tumors or liver disease
- increased clotting or stroke risk
- or if pregnant.
Smoking increases the risk of serious heart side effects when using a combined estrogen and progestin birth control, including the ring or the patch. This risk increases with heavy smoking (more than15 cigarettes per day). Combination estrogen and progestin birth control should NOT be used in women over 35 years of age who smoke due to an increased risk of rare but serious side effects, such as heart attack, blood clots, and stroke.
Women of any age should avoid combination hormonal birth control if they have a history of:
- uncontrolled high blood pressure
- chest pain
- severe headaches
- heart or liver disease
- blood clots or stroke.
Cardiovascular risks increase with age, weight, family history of heart disease, and number of cigarettes smoked per day.
Let your physician know if you have migraine headaches when discussing birth control options.
The birth control pill does not protect against any form of sexually transmitted disease (STD), including HIV and AIDS. A male latex or female condom should be used in combination with any other form of birth control for protection against STDs.
Can I Take the Pill if I am Breastfeeding?
Breastfeeding mothers should avoid estrogen in combination hormonal birth control (which contain both estrogen and progestin) as it may reduce milk supply. Birth control options for breastfeeding women include IUDs, progestin only pills (“mini-pills”), the implant or the birth control shot.3
What Are the Common Side Effects with Birth Control Pills?
- Spotting between periods (breakthrough bleeding)
- Possible weight gain or fluid retention
- Breast swelling or tenderness
- Nausea or upset stomach
- Mood changes
What Are the Serious Side Effects with Birth Control Pills?
- Blurred vision
- Severe stomach pain
- Severe headache
- Swelling or pain in the legs
- Chest pain, heart attack, blood clots, stroke
- Birth Control Pills
- Birth Control Pills - Breakthrough Bleeding
- Birth Control Pills - Periods
- Emergency Contraception
- Grapefruit and Birth Control Pills
- Hormonal Birth Control (Non-Pill Options)
- Missed taking your birth control pill?
- Non-hormonal Birth Control
- Permanent Birth Control
- Planned Parenthood. Website. Birth Control Pills. Accessed March 19, 2018 at http://www.plannedparenthood.org/health-topics/birth-control/birth-control-pill-4228.htm
- American College of Obstetrics and Gynecology (ACOG): Birth Control Pills. FAQ012 Contraception. Accessed March 19, 2018 at https://www.acog.org/Womens-Health/Birth-Control-Contraception#Patient
- U.S. Food and Drug Administration (FDA). Birth Control Guide. Accessed March 19, 2018 at http://www.fda.gov/ForConsumers/ByAudience/ForWomen/FreePublications/ucm313215.htm
- New Zealand Family Planning. Progestin-Only Contraceptive Pill. Advice. 2018. Accessed March 19, 2018 at http://www.familyplanning.org.nz/advice/contraception/progestogen-only-contraceptive-pill