Should You Worry About Taking Birth Control Pills?

 

By: Favour Okere. BNSc. RN. Freelance Health Writer. Medically reviewed by Dr. O. Oni. MD.

Satchets of birth control pills.

 

Key Facts 

• There are two main types of birth control pills (BCPs). They include combination pills and progestin-only pills (mini-pills).

• BCPs work primarily by preventing ovulation, thickening cervical mucus, and thinning the uterine lining.

• BCPs do not only prevent pregnancy, they can also help to regulate menstrual cycles, reduce acne, and lower the risk of certain cancers.

• BCPs are not recommended for smokers over 35, women with a history of blood clots, or liver disease.

• If you can't or dislike birth control pills, alternatives include IUDs, contraceptive implants, injections, barrier methods, and natural family planning.

 

Introduction 

It is normal for most women to get anxious and confused when it comes to taking birth control pills (BCPs). This could be because they know little or nothing about BCPs, or due to their exposure to many myths and misconceptions about BCPs.

However, for decades, birth control pills have been a reliable and convenient way of preventing unintended pregnancies and managing other aspects of reproductive health. They not only prevent pregnancy but also reduce the risk of endometrial and ovarian cancer and protect against acute pelvic inflammatory disease and ectopic pregnancies. [1]

Just like other medications, birth control pills come with their own risks and side effects. This article will cover all you need to know about birth control pills. From their benefits to their risks and myths, so you can make an informed choice whether or not you should worry about taking them. 

 

What are Birth Control Pills?

To address your concern about birth control pills, it's important that you first know what birth control pills are and exactly how they work. Birth control pills (BCPs) or oral contraceptives, are hormone-based medications that are taken daily to prevent pregnancy. They contain man-made versions of the female hormones estrogen and progesterone, or only progesterone. [2]

Hormones are chemical substances that control the functioning of the body's organs. [3] The hormones in BCPs control the ovaries and uterus and effectively prevent ovulation.

 

Types of Birth Control Pills

There are two main types of birth control pills. BCPs are either combined estrogen-progesterone (also called combined oral contraceptive pill-COC) or progesterone-only pill (POP). [4] Each type has its own unique advantages and disadvantages. 

I. Combination Pills

Combination pills contain both estrogen and progestin (a synthetic form of progesterone). [5] They are the longest-established and most common type of birth control pills. [6] COCs are said to be a great choice for the following reasons:

Pros:

• Highly effective although effectiveness depends on the user. If used correctly, at least 99% effective in preventing pregnancy. If used incorrectly, about 93% effective [7]

• COCs reduce functional androgen levels thereby reducing sebum production and acne [8]

• Can be useful in the treatment of endometriosis, dysmenorrhea and polycystic ovary syndrome [9]

• Reduces risk of endometrial, ovarian and colorectal cancer [10]

However, there are a few major concerns about the use of combined pills ranging from their side effects to their exclusivity. 

Cons:

• May cause side effects like high blood pressure, dizziness and sore breasts [11]

• Not suitable for those with high blood pressure, a history of blood clots or stroke

• Not suitable for smokers over 35 [12]

II. Progestin-Only Pills (Mini-Pills)

Progestin-only pills (POPs) contain only progestin. They are popularly known as “mini-pills.” Many people can use POPs unlike COCs. Their advantages include:

Pros:

• Recommended if you can't use COCs due to health reasons

• Can be used by women at any age

• POPs are breastfeeding-friendly 

• POPs have fewer hormonal side effects when compared to COCs.

However, there are still a few concerns associated with the use of POPs. They include:

Cons:

• Must be taken at the same time every day for maximum effectiveness

• May cause weight gain

• May affect your sex drive

• May cause irregular bleeding [13]

 

How do Birth Control Pills Work?

Birth control pills primarily work by regulating reproductive hormones to prevent you from getting pregnant. They do this by suppressing the release of eggs from the ovaries. The hormones in the pills can also thicken cervical mucus. This makes it harder for sperm to reach the egg. 

COCs also work by thinning the uterine lining thereby reducing the likelihood of a fertilized egg implanting.

The effectiveness of hormonal contraceptives may be reduced by medications like antibiotics, antifungals, antihypertensives, cholesterol-lowering drugs, or herbs. Also, if you take the pill and vomit or have diarrhea, the pill may no longer provide enough protection. You may have to use another form of contraception too e.g. a condom. [8]

 

Myths about Birth Control Pills 

There are a lot of myths about the use of birth control pills that might make you unnecessarily worried. Common myths include that BCPs can make you infertile and are ineffective when taken with antibiotics.  Some also claim that BCPs are unsuitable for long-term use. 

However, it might shock you to know all these myths, although popular, are not backed by any scientific evidence! There is no evidence that suggest that BCPs can cause permanent infertility.  In fact, most people safely use them for many years. And when they choose to get pregnant, they stop using them and can still conceive. Also, it is not scientifically proven that BCPs are less effective when taken with antibiotics. 

You should distinguish the myths and misconceptions about BCPs from the actual risks and benefits of BCPs to alleviate your anxiety and prevent unnecessary worry.

 

Benefits of Birth Control Pills

• The birth control pill is a simple and effective way of preventing unintended pregnancies

• They can help make your periods more regular, lighter, and less painful

• BCPs can help in managing conditions like endometriosis, dysmenorrhea and polycystic ovary syndrome (PCOS)

• If you use the pill for long, it may help lower the risk of ovarian and endometrial cancers

• BCPs can reduce your acne and make your skin clearer [14]

 

Who Can Use Birth Control Pills?

Birth control pills are suitable for most healthy women of reproductive age, including those who:

• Want a simple but very effective method of preventing pregnancy

• Are experiencing irregular cycles and wish to regulate their menstrual cycles

• Are seeking treatment for  heavy or painful periods

• Are looking for treatment for acne or PCOS symptoms

 

Who Should Not Use Birth Control Pills?

While birth control pills are safe for many, they are not recommended for everyone. Women who should avoid or use caution with birth control pills include:

• Smokers over 35 years old

• Women with uncontrolled hypertension

• Those with a history of blood clots such as Deep Venous Thrombosis (DVT)

• Women with liver disease

• Women who have 2 or more risk factors for cardiovascular diseases, such as older age, diabetes, hypertension, or smoking, should also not use COC as the risk outweighs the benefits.

• Women with thrombogenic mutations – a specific type of genetic change that results in increased tendency to form blood clots that can block blood vessels (thrombophilia)

• Those with certain types of cancer

• Those who are pregnant or suspect they might be

• Women with undiagnosed abnormal uterine bleeding [4].

 

Common Concerns and Potential Risks

BCPs come with potential risks and side effects like other medications. However, serious side effects are rare, and many women use birth control pills without any significant issues.

• Although rare, smokers have a slightly higher chance of developing blood clots when on BCPs [15]

• Minor weight gain or loss may occur when on the pill

• It is also common to experience breakthrough bleeding in between your periods in the first few months of use

• You may also have mood swings or depression

• Some women report a lower sex drive while on the pill

• Some medications can reduce the effectiveness of birth control pills, including certain antibiotics and anticonvulsants

 

Alternatives to Birth Control Pills

If you are still concerned or choose not to use birth control pills, several alternatives are available:

• Barrier Methods: Both male and female condoms provide a barrier that prevents pregnancy and also protects against sexually transmitted infections (STIs). Other barrier methods for women include diaphragms and cervical caps

• Intrauterine Devices (IUDs): These are long-term reversible contraceptives that can be hormonal or non-hormonal

• Contraceptive Implant: The implant is a small rod placed under the skin of the upper arm that releases hormones

• Contraceptive Injection: The injectable form of birth control protects for three months

• Natural Family Planning: Tracking fertility signs to avoid pregnancy

• Sterilization: A permanent option if you no longer want children

 

Factors to Consider When Choosing a Birth Control Method

Choosing to use a birth control method is a personal decision that depends on various factors. If you decide to choose a birth control method, then you should consider the following:

• Effectiveness: Check out how effective the method is.  How important is it to you to prevent pregnancy?

• Side Effects: How sensitive are you to hormonal changes?

• Lifestyle: You should consider if the method suits your lifestyle. Are you comfortable with taking pills every day or would you rather go for a longer-acting method?

• Health History: Do you have any existing health conditions that might influence your choice?

• Cost and Accessibility: Consider the cost and availability of the method. Know which your insurance covers and what you can afford

• Future fertility plans: Do you want to have children? If yes, when? 

 

Why You Should Talk with Your Healthcare Provider

Even if you now understand all you need to know about birth control pills, other concerns may arise in the future.  So, before starting birth control pills or any contraceptive method, you have to consult your healthcare provider. Your healthcare provider can:

• Offer you professional advice based on your health history to ensure birth control pills are safe for you

• Provide regular check-ups to monitor your health status

• Explain how to correctly use the pill and what to do if you miss a pill

• Inform you about potential side effects and how you can manage them

• Correctly answer other questions you may have about your reproductive health.

 

Conclusion

The birth control pill is an easy and reliable method for managing reproductive health.  Although they come with lots of benefits, they still have their risks and side effects. Whether or not you should worry about using them depends on how much you really know about them, the myths you have been exposed to and your openness to learning accurate information. 

Understanding the types of birth control pills available, how they work, and their potential effects on your body is important in making informed decisions. What works best for another person may not be ideal for you. So, ensure you always stay informed.

Also, speak freely to your healthcare provider about your health needs, lifestyle, and reproductive goals. By clearly knowing your options, you can make a confident choice that supports your overall health and gives you peace of mind in your family planning journey.

 

References

1. National Research Council (US) Committee on Contraceptive Benefits and Risks. Contraception and Reproduction: Health Consequences for Women and Children in the Developing World [Internet]. National Academies Press (US), 1989. 4 [Cited 2024 August 25]. Available from here

2. NIH. National Library of Medicine. MedlinePlus. [Internet]. Birth Control Pills. Reviewed 2024 March 31. [Cited 2024 Aug 25] Available from here

3. Nemours Teens Health. Birth Control (Contraceptive) Pill [Internet]. Reviewed 2022 Jan. [Cited 2024 Aug 26] Available from here

4. Cooper DB, Patel P. Oral Contraceptive Pills. [Updated 2024 Feb 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. [Cited 2024 Aug 25]. Available from here

5. Casey, FE. Hormonal Methods of Contraception. MSD Manual Consumer Version, Revised August 2023. [Cited 2024 Aug 25]. Available from here  

6. Kheloui, S. and Ismail, N. Synthetic Sex Hormones and Cognition. Reference Module in Neuroscience and Biobehavioral Psychology, Elsevier, 2024. DOI: 10.1016/B978-0-12-820480-1.00067-X. Available from here 

7. World Health Organization (WHO). Family Planning: A Global Handbook for Providers. [Internet]. 2022 November 14. [Cited 2024 August 25]. Available from here  

8. Institute for Quality and Efficiency in Health Care (IQWiG). Acne: Research summaries – Which birth control pills can help reduce acne? [Internet]. Updated 2022 Dec 5. [Cited 2024 Aug 25] Available from here

9. Kitson, J. Benefits and Risks of Combined Hormonal Contraception.” Prescriber, 2022 June, vol. 33, no. 6, pp. 29–33. DOI: org/10.1002/psb.1994. Available from here 

10. Coelingh B., Van Gennip F., Gerrits M. et al. Health Benefits of Combined Oral Contraceptives - A Narrative Review. Eur J Contracept Reprod Health Care. 2024 Apr; 29;2, 40-52. DOI: 10.1080/13625187.2024.2317295. Available from here 

11. NHS UK. Side Effects and Risks of the Combined Pill [Internet]. Last reviewed 2024 Feb. 15. [Cited 2024 Aug 25]. Available from here 

12. University of Mary Washington Student Health Center. Who Shouldn’t Take the Pill? [Internet, n.d]. [Cited 2024 Aug 26]. Available from here

13. NHS UK. Side Effects and Risks of the Progestogen-Only Pill [Internet]. 29 Feb. 2024 [Cited 2024 Aug 26]. Available from here 

14. Planned Parenthood Federation of America. What Are the Benefits & Advantages of Birth Control Pills? [Internet, n.d]. [Cited 2024 Aug 25]. Available from here 

15. Jefferson Health. The Pill and Smoking: Understanding the Risks [Internet, n.d] [Cited 2024 Aug 25]. Available from here. 

 

Related: 

Birth control pills in Nigeria: Common myths and Misinformation

Unmet Need For Contraception in African Women

Why Family Planning Is Essential To Nigerian Women Of Reproductive Age

 

Click on the video below to learn more about birth control pills, how they work and your options.

 

 

Published: September 11, 2024

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