While this article focuses on the possible side effects and risks of taking the birth control pill (commonly known as “the pill”), we should start by saying that this is a popular and highly effective form of birth control.
It’s also important to note that there are different brands and formulations of hormonal birth control pills and side effects that may be experienced with one brand, may not happen with another. Always work with your doctor to form the best approach to birth control.
Considerations for Using the Birth Control Pill
According to Planned Parenthood, hormonal birth control pills are 99% effective when used correctly to prevent pregnancy. However, there are some considerations apart from risks to take into account when choosing this form of birth control:
- Prescription: The pill is a prescription drug so will require you to see your doctor for an initial prescription as well as renewals. This may be inconvenient for some.
- Cost: The birth control pill may be costly for some women, especially if not covered by healthcare insurance. This may make it a difficult form of birth control to use consistently for some.
- Remembering to take the pill every day: The main thing that makes the pill stop working is forgetting to take it every day. Because forgetfulness is such a common, human mistake, the reality of effectiveness can be lessened to about 91% effectiveness when pills are not taken every day.
- STIs: While birth control pills are effective at preventing pregnancy, they do not protect you from STIs. Condoms can be used to supplement the pill and protect you from STIs, thereby giving you a double-whammy of birth control to prevent pregnancy and reduce risk of STIs.
- Drug interactions: Certain medicines and supplements can compromise the effectiveness of birth control pills. These include the antibiotic Rifampin, antifungal Griseofulvin, certain anti-seizure medicines and the herb St. John’s Wort.
According to ACOG:
“With typical use—meaning that the method may not always be used consistently or correctly—9 women out of 100 (9%) will become pregnant during the first year of using these methods. With perfect use—meaning that the method is used consistently and correctly each time—fewer than 1 woman out of 100 will become pregnant during the first year.”
Side Effects of Birth Control Pills
All forms of hormonal birth control can cause a range of side effects. Most of the common side effects are mild and may resolve after the first two or three months of taking the pill.
Common Side Effects of Birth Control Pills
There are some common side effects of taking the birth control pill. These may be felt more keenly when you first begin taking the pill and may taper off once your body adjusts to the hormonal medication.
While none of these is a cause for alarm in itself, do seek medical advice if you are troubled by any symptoms or find them impacting your quality of life.
- Short term weight gain
- Sore or swollen breasts
- Small amounts of spotting, called breakthrough bleeding
- Lighter periods
- Mood changes
Serious Side Effects (ACHES)
There are some side effects that are considered more serious and warrant immediate medical attention. These are easily remembered with the acronym ACHES. If you experience any of these symptoms, according to the Department of Health and Human Services, you should seek immediate medical attention, which includes a trip to Emergency if your doctor is unavailable.
- Abdominal severe pain (stomach pain): May mean a possible ruptured liver tumor, cyst, tubal pregnancy.
- Chest pain: May mean possible heart attack; sudden shortness of breath, persistent cough or coughing up blood indicating possible blood clot in lungs.
- Headaches (sudden and severe) or vomiting, dizziness or fainting, weakness or numbness in an arm or leg or disturbances of speech may mean a possible stroke.
- Eye problems: Blurring vision, flashing lights or partial/complete loss of vision may mean a possible clot in the eye or other blood flow problems.
- Swelling or aching in the legs and thighs: Sudden leg pain in calf or thigh or redness, heat or swelling in calf or thigh, may mean possible blood clots.
Risks of the Pill
Nearly all forms of birth control involving estrogen can increase your risk of certain health problems. But according to Planned Parenthood, these risks aren’t common. More serious potential side effects of birth control pills include:
According to ACOG, these risks are higher in some women, including women older than 35 years who smoke more than 15 cigarettes a day or women who have multiple risk factors for cardiovascular disease, such as high cholesterol, high blood pressure, and diabetes; a history of stroke, heart attack, or deep vein thrombosis (DVT); or a history of migraine headaches with aura.
- Blood clots
- Gallbladder disease
- Heart attack
- High blood pressure
- Liver cancer
To Minimize Risks, Inform Your Doctor if...
Birth control pills can be taken safely by most women. However, you should fully disclose your medical history to your doctor when considering taking the pill. Similarly, you should disclose if a close relative has suffered any of the following. Your doctor will likely recommend you do not take hormonal contraceptives if you have ever had:
- Blood clots in the arms, legs, or lungs
- Serious heart or liver disease
- Cancer of the breast or uterus
- Uncontrolled high blood pressure
- Migraines with aura
- Heart attack or stroke
Benefits of Taking the Pill
Okay, that probably has made for some pretty scary reading. But remember there’s usually a long list of possible side effects with any prescription drug. The best thing to do is to work closely with your doctor to determine what form of birth control is right for you.
Do not make a decision based on information you read online. Instead, make a list of questions and concerns based on what you’ve read, and ask your doctor if these concerns apply to you.
Risks and side effects aside, the birth control pill has many benefits. Indeed, many women are prescribed birth control pills for other health reasons. Moreover, with a <1% failure rate, the pill is a very effective form of birth control.
Lightens Menstrual Period Flow
Many women experience heavy bleeding during their period. This is called Menorrhagia. Some women just have a heavier flow. But for others, it is caused by medical issues like endometriosis or fibroid tumors. This may also be accompanied by severe pain and cramping.
The birth control pill can lighten a woman’s menstrual flow and reduce the severity of pain experienced during her monthly period.
Reduces Risk of Pelvic Inflammatory Disease (PID)
The pill prevents ovulation and also causes your body to create thicker cervical mucus, making it more challenging for sperm, but also bacteria, to reach your uterus, fallopian tubes and ovaries.
This may help protect you from developing Pelvic Inflammatory Disease (PID), a condition which is caused by untreated sexually transmitted diseases. However, as noted earlier, the pill does not itself protect you from STIs — you should still use a condom.
Cancer Risk May Decrease
Many women worry about a causal connection between the birth control pill and cancer. However, the answer is complex and depends on the kind of cancer under discussion and an individual’s genetics or other inherited risk factors. If you have a history of cancer in your family, you should discuss this with your doctor when considering the pill.
However, studies by the Memorial Sloan Kettering Cancer Centre have also shown that birth control pills may lower your risk for both ovarian cancer and endometrial cancer. After five years of use, your risk of developing ovarian cancer decreases by about 50 percent. For endometrial cancer, the protective effect increases with the length of time oral contraceptives are used and continues for several years after you stop taking them.
Mood Changes Can Decrease
Some women experience extreme mood changes throughout their cycle as a result of changing hormone levels. The pills can prevent this rollercoaster of emotions for many women, resulting in a more “even-keeled” mood.
Excess Body Hair and Acne Improvements
Some women find that excess hair and acne may be improved while on the birth control pill. While this alone is not a reason to take the pill, it may be a “cherry on top” for those who find the pill to be their ideal form of birth control and who also experience these benefits.
Alternatives Forms of Birth Control
If you wish to stop using hormonal birth control (for whatever reason), but don’t want to become pregnant, there are other contraceptives you can consider. You can learn more about birth control options from Planned Parenthood.
Non-hormonal birth control methods include:
- Copper IUD
- Surgical cap
- Fertility awareness method (FAM)
Obviously sterilization is a more extreme, and permanent, solution. But depending on a woman’s medical situation, it might be an option she and her doctor want to explore.
In general, it’s always a good idea to consult with your healthcare provider to determine your options and what form of birth control would be right for you and your partner.
Factors to Consider When Choosing Birth Control
Choosing the right birth control method is a very personal decision and there is no “one shoe fits all” solution that applies to everybody. We really recommend working with your healthcare provider to determine the best choice for you.
Your doctor will take your medical history, lifestyle (especially if you smoke and your body weight), personal requirements, budget and more into consideration when recommending the right birth control method for you.
Some important factors to consider include, your:
- Overall health and medical history
- Desire want to have children in the future
- Frequency of intercourse
- Number of sexual partners
- Your budget and affordability of birth control methods
- Ability to “stick” to a habit of using / taking birth control