MEDICINE : BIRTH CONTROL PILLS-- WHAT ARE THE RISKS?

DR. MARTIN

Oral contraception has revolutionized women’s reproductive and social freedoms. They are very safe, effective and widely used. There are, however, some rare risks that women taking these medicines should be aware of. It’s important to thoroughly discuss your and your family’s medical history and all the medicines you’re taking with your health care provider.

This is a summary of what the medical literature shows. As usual, some of the findings are contradictory, but patterns do emerge.

Breast Cancer

Large studies show that the risk of breast cancer with birth control pills (BCP) is very slightly increased, but diminishes back to normal after stopping the medicines for 10 years. It’s important to note that women with a family history of breast cancer or other risk factors appear to have no increased risk of cancer from BCP compared with women taking BCP who have no risk factors.

Ovarian Cancer

The risk of ovarian cancer is reduced with BCP. The risk drops after just a few months of use and adds up with time. The longer the use of BCP, the less the risk is of ovarian cancer.

Endometrial (uterine) Cancer

BCP have a protective effect and reduce the risk of endometrial cancer, even long after a woman stops taking them.

Cervical Cancer

The risk of cervical cancer in women using BCP is very slightly increased in women who are Human Papilloma Virus positive. In other words, women with HPV infections and taking BCP may have a slightly higher risk for cervical cancer than HPV positive women not taking BCP. But the risk for women without this infection who are taking BCP is not increased.

(Get the vaccine and practice safe sex!)

Cardiovascular Disease

The data here is conflicting. If there is an increased risk for cardiovascular problems such as strokes or heart attacks, it is very small and usually occurs in women over 35. But if a woman has high blood pressure or smokes, then the increased risk is real. Bottom line, if you smoke, you should understand that you are increasing your risk of cardiovascular problems if you take BCP. If you have high blood pressure, it should be well controlled before you start taking BCP.

When a woman stops taking BCP, the risk of a cardiovascular problem returns to normal.

Deep Venous Thrombosis (Blood Clots)

The risk for a serious clot is increased 4-5 times in women taking BCP. Keep in mind that this is a rare (1 in a thousand), but serious event. Smokers or women who have a genetic predisposition to clotting are at even higher risk. The risk is highest during the first year of use and drops to normal after stopping BCP. Symptoms, when they do occur, are usually leg pain and swelling.

Reading all this may be frightening, but feel reassured that the risk of problems while taking BCP is pretty much the same as not taking them except for venous clotting. It’s no surprise that smoking increases the chance of these rare problems occurring. Yet another reason not to smoke.

BCP do not protect against sexually transmitted diseases, only pregnancy. Practice safe sex!

The Doctor Behind the Medicine: 

Dr. Martin went to medical school at UCSF. He has now retired from his long and brilliant career as an anesthesiologist, now playing guitar and making bread on his spare time. Dr. Martin and three associates have started a delicious commercial wine, MC4. For those who are 21 and older, I advise you to check out MC4-- cheers!