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Birth control pill FAQ: Benefits, risks and choices
If you've been taking birth control pills for many years and decide to stop, can you stop at any time or should you finish your current pill packet?
In terms of your overall health, it makes little difference when you stop taking the pill. When you finally do stop the pill, you can expect some bleeding, which may change the rhythm of your menstrual cycle. But you can stop at any time.
Can you get pregnant during the week that you take the nonactive (placebo) pills?
Taking the nonactive pills doesn't put you at higher risk of unintended pregnancy. If you're taking your birth control pills exactly as directed, they're 98 percent to 99 percent effective at preventing pregnancy.
If, however, you've missed a dose — or several doses — during a cycle, you might be at higher risk of unintended pregnancy during that cycle. To be safe, use a backup form of contraception, such as a condom.
Do birth control pills cause weight gain?
Lots of women think so. But studies have shown that the effect of the birth control pill on weight is small — if it exists at all.
Instead, you may be retaining more fluid, which can make you feel as if you've put on weight, particularly in your breasts, hips and thighs. The estrogen in birth control pills does affect fat (adipose) cells, making them larger but not more numerous.
In rare circumstances, women may add muscle, which can add weight, when taking the pill. This is due to the slight male-sex-hormone effect that the pill may have on some women.
Whether this side effect shows up when you get on the scale or only when you look in the mirror, you may not like it. Taking pills with a low dose of estrogen may diminish the effect, but you may also experience a greater risk of spotting between periods.
How do birth control pills affect your risk of cancer?
Scientific evidence suggests using birth control pills for longer periods of time increases your risk of some cancers, such as cervical cancer and liver cancer, but it also decreases your risk of other types of cancer, including ovarian cancer and endometrial cancer.
The effect of birth control pills on breast cancer risk isn't quite clear. However, some studies do show a link between pill use and breast cancer. Key factors seem to be how many years you take the pill and how recently you last used the pill. In one study, use of birth control pills led to a higher risk of premenopausal breast cancer in women who took the pill for four or more years before having a baby. Other evidence suggests that 10 or more years after you stop taking the pill, your breast cancer risk returns to the same level as if you had never taken birth control pills.
Do birth control pills affect cholesterol levels?
Birth control pills can affect cholesterol levels. How much of an effect depends on the type of pill you're taking and what concentration of estrogen or progestin it contains.
The estrogen in birth control pills causes an increase in high-density lipoprotein (HDL) cholesterol levels (the "good" cholesterol), a decrease in low-density lipoprotein (LDL) cholesterol levels (the "bad" cholesterol) and an increase in your total cholesterol and triglyceride levels. Progestin in birth control pills has the opposite effect.
Birth control pills with a greater concentration of estrogen can have a slightly beneficial overall effect on your blood lipid levels. In general, though, the changes aren't significant and don't affect your overall health.
Do birth control pills affect blood pressure?
Birth control pills may increase blood pressure. The risk of high blood pressure in women who take birth control pills also increases with age and the duration of use.
If you take birth control pills, have your blood pressure checked regularly. If you already have high blood pressure, consider an alternative form of birth control. If you do choose to take the pill, have your blood pressure closely monitored by your doctor.
If you develop high blood pressure while taking the pill, give serious thought to switching to another form of contraception.
What's the risk of smoking if you're over age 35 and taking birth control pills?
Birth control pills aren't recommended for women over age 35 who smoke because it increases the risk of cardiovascular disease. If you're 35 or older, and you smoke, you need to quit smoking before you can safely continue using your birth control pill.
Can antibiotics decrease the effectiveness of birth control pills?
The effects of antibiotics on birth control pills may be overstated — except in the case of one antibiotic, rifampin. Studies clearly show that rifampin decreases the effectiveness of birth control pills in preventing ovulation. However, rifampin isn't used widely. Chances are you wouldn't be taking it unless you had tuberculosis or had tested positive for the disease.
Hypothetically speaking, other antibiotics, particularly penicillin and tetracycline derivatives, could impair the effectiveness of birth control pills in a small percentage of women. Researchers can't rule out this possibility, but no large studies have proved such an effect.
If you're taking a newer, extremely low-dose oral contraceptive, you could be more susceptible to this potential antibiotic effect. If you're concerned, consider using a barrier method of contraception for the duration of your antibiotic prescription.
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- Oral contraceptives and cancer risk: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Risk/oral-contraceptives. Accessed March 30, 2009.
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