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Birth Control Pills Advantages and Disadvantages
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Birth Control Pills Advantages and Disadvantages

Oral contraceptives consist of synthetic forms of two hormones produced naturally in the body: either progestin alone or estrogen and progestin. Estrogen and progestin regulate a woman's menstrual cycle, and the fluctuating levels of these hormones play an essential role in fertility.

Health benefits and advantages

Birth control pills provide certain health benefits in addition to preventing pregnancy.

  • Highly effective reversible contraception. Birth control pills provide highly reliable contraceptive protection, exceeding 99%. Even when imperfect use (skipping an occasional pill) is considered, the BCPs are still very effective in preventing pregnancy.
  • Menstrual cycle regulation. Birth control pills cause menstrual cycles to occur regularly and predictably. This is especially helpful for women with periods that come too often or too infrequently. Periods also tend to be lighter and shorter.
  • Reduce menstrual cramps. Birth control pills can offer significant relief to women with painful menstrual cramps (dysmenorrhea).
  • Decreased risk of iron deficiency (anemia). Birth control pills reduce the amount of blood flow during the period. Less blood loss is helpful in preventing anemia.
  • Reduce the risk of ovarian cysts. The risk of developing ovarian cysts is greatly reduced for birth control pills users because they help prevent ovulation. An ovarian cyst is a fluid - filled growth that can develop in the ovary during ovulation (the release of an egg from an ovary).
  • Protection against pelvic inflammatory disease. Birth control pills provide some protection against pelvic inflammatory disease (PID). Pelvic inflammatory disease is a serious bacterial infection of the fallopian tubes and uterus that can result in severe pain and potentially, infertility.
  • Can improve acne. Birth control pills can improve acne. For moderate to severe acne, which other medications can't cure, birth control pills may be prescribed. The hormones in the birth control pill can help stop acne from forming.
  • Reduces the risk of symptomatic endometriosis. Women who have endometriosis tend to have less pelvic pain and fewer other symptoms when they are on the Pill. Birth control pills won't cure endometriosis but it may stop the disease from progressing. The pills are the first-choice treatment for controlling endometriosis growth and pain. This is because birth control hormones are the hormone therapy that is least likely to cause bad side effects.
  • Improves fibrocystic breasts. 70 - 90% of patients see improvement in the symptoms of fibrocystic breast conditions with use of oral contraceptives.
  • Improved excess hair (hirsutism). Women with excessive facial or body hair may notice an improvement while taking the Pill, because androgens and testosterone are suppressed by oral contraceptives. High androgen levels can cause darkening of facial and body hair, especially on the chin, chest, and abdomen.
  • Prevents ectopic pregnancy. Because birth control pills work primarily by suppressing ovulation, they effectively prevent ectopic pregnancy as well as normal pregnancy. This makes the pills an excellent contraceptive choice for women who are at particular risk for ectopic pregnancy, a potentially life-threatening condition.
  • Helps prevent osteoporosis. Several studies show that by regulating hormones, the pill can help prevent osteoporosis, a gradual weakening of the bones. However, the results of different studies are conflicting (1-3).
  • Does not affect future fertility. Using the pills will not affect a woman’s future fertility, although it may take two to three months longer to get pregnant than if a woman did not take pills.
  • Easy to use. Does not interrupt foreplay or sexual intercourse.
  • Safe for many women. Research for over 40 years has proven long term safety.

Risks and disadvantages

About 40% of women who take birth-control pills will have side effects of one kind or another during the first three months of use. The vast majority of women have only minor, transient undesired effects. Some side effects are uncommon but may be dangerous.

  • Heart attack. The chances of birth control pills contributing to a heart attack are small unless you smoke. Studies have shown that smoking dramatically increases the risk of heart attack in women age 35 years or older, which is why pills are generally not prescribed to women in this age group who smoke.
  • Blood pressure. Women taking birth control pills usually have a small increase in both systolic and diastolic blood pressure, although readings usually remain within the normal range. Blood pressure should be closely monitored for several months after a women starts taking oral contraceptives, and followed yearly thereafter.
  • Migraines and stroke. Women who take oral contraceptive and have a history of migraines have an increased risk of stroke compared to nonusers with a history of migraine4.
  • Blood clots (Venous thromboembolism). Women who use birth control pills are at a slightly increased risk of having a blood clot in the legs or lungs. Studies consistently show that the risk of venous thromboembolism (VTE) is two to six times higher in oral contraceptive users than in nonusers. The risk of blood clots is highest in women with clotting disorders or who have previously had a deep venous thrombosis or pulmonary embolism. Other risk factors include obesity, older age, having several family members who've had blood clots before old age, air travel, and having to lie or sit for a prolonged period, as you might after major surgery.
  • Headaches. Headaches may start in women who have not previously had headaches, or can get worse in those who do.
  • Depression. Depression (sometimes severe) and other mood changes may occur.
  • Nausea and vomiting. This side effect usually goes away after the first few months of use or can be prevented by taking the pill with a meal.
  • Breast tenderness. Your breasts may become tender or may get larger. Breast tenderness is relatively common during the first month of BCPs and uncommon thereafter.
  • Breakthrough bleeding or spotting. Spotting or bleeding between menstrual periods is very common in the first cycle of pills or if pills are missed or taken late.
  • Decreased enjoyment of sex. Some women experience a decreased interest in sex or a decreased ability to have orgasms.
  • Weight gain. Some women report slight weight gain. Weight gain is often caused by fluid retention or estrogen-induced fat deposits in the thighs, hips, and breasts. Weight gain may also be related to a reduction in physical activity or increased intake of food. In some women the androgenic effects from the progestins in their OCs can increase their appetite.
  • Chloasma (spotty darkening of the skin on the face). Darkening of the skin on the upper lip, under the eyes, or on the forehead (chloasma). This may slowly fade after you stop taking the pills, but in most cases, it is permanent.
  • Drug interactions. Birth control pills may not be as effective if you are taking certain medications. Some antibiotics, antifungals, anticonvulsants, herbs like St. John's Wort, can change the amount of the contraceptive hormones absorbed by the stomach and the metabolism of these hormones.
  • Not suitable for everyone. Some women should not take pills if they have specific health conditions, including some types of diabetes, liver disease, cardiovascular disease. Women with risk factors for heart disease, such as those with high blood pressure or who are obese, are also at higher risk when on the Pill.
  • Sexually transmitted diseases. Birth control pill does not offer any protection against sexually transmitted infections.
  • Must be taken every day. You must remember to take the pills at the same time every day. Pills must be taken every day, even if a woman does not have intercourse that day. Must use a secondary form of birth control for the initial seven days of use.
  • Diarrhea or vomiting. Anything that makes the pill go through your system too fast can make the pill not work as well because it was not absorbed or, worse, if it is lost in the vomit.
  • Progestogen-only contraceptives may worsen the results of the glucose tolerance test.
  • Cost. The pill costs more than other methods of contraception.

References
  • 1. Corson SL. Oral contraceptives for the prevention of osteoporosis. J Reprod Med. 1993 Dec;38(12 Suppl):1015-20. PubMed
  • 2. Cooper C, Hannaford P, Croft P, Kay CR. Oral contraceptive pill use and fractures in women: a prospective study. Bone. 1993;14(1):41-5. PubMed
  • 3. Lindsay R, Tohme J, Kanders B. The effect of oral contraceptive use on vertebral bone mass in pre- and post-menopausal women. Contraception. 1986 Oct;34(4):333-40. PubMed
  • 4. Allais G, Gabellari IC, Mana O, Schiapparelli P, Terzi MG, Benedetto C. Migraine and stroke: the role of oral contraceptives. Neurol Sci. 2008 May;29 Suppl 1:S12-4.
  • 5. Schindler AE. Non-contraceptive benefits of oral hormonal contraceptives. Int J Endocrinol Metab. 2013 Winter;11(1):41-7.

Published: May 05, 2007
Last updated: August 05, 2013

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