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
- 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
- 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,
- 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
- 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
- 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
- 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
- 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.
- Glaucoma. Taking oral contraceptives for more than 3 years significantly increases the risk of glaucoma7.
- Progestogen-only contraceptives may worsen the results of the glucose tolerance test.
- Cost. The pill costs more than other methods of contraception.
Long-term use and risk of death
Latest 2014 study revealed that risk of death did not significantly differ between women
who had ever used birth control pills and those who had never used them6.
- 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.
- 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.
- 6. Charlton BM, Rich-Edwards JW, Colditz GA, Missmer SA, Rosner BA, Hankinson SE, Speizer FE, Michels KB. Oral contraceptive use and mortality after 36 years of follow-up in the Nurses' Health Study. BMJ. 2014 Oct 31;349. PubMed
- 7. American Academy of Ophthalmology. 2013 Annual Meeting. Presented November 18, 2013.
Published: May 05, 2007
Last updated: January 14, 2015