Birth Control Pills (cont.)
Louise Chang, MD
Dr. Chang completed her undergraduate degree at Stanford University and attended medical school at New York Medical College. She completed her internal medicine residency at Saint Vincent's Hospital in New York City, where she also served as a chief resident from 2001-2002. Dr. Chang is board-certified in internal medicine.
In this Article
- What are birth control pills and how do they work?
- What are the different types of birth control pills?
- Are there differences among birth control pills?
- What are the side effects/health risks of birth control pills?
- What are the drug interactions of birth control pills?
Are there differences among birth control pills?
Birth control pills can differ not only in the number of active ingredients, but also in the way ingredients are dosed:
Monophasic birth control pills contain the same amount of ingredient in each active pill.
Multiphasic birth control pills contain varying levels of hormones through the month. They were designed to minimize side effects such as breakthrough bleeding, which is bleeding that occurs between menstrual periods.
Low-dose oral contraceptives contain less estrogen than other types of birth control pills. They contain 20 micrograms of estrogen, compared to 30 to 50 in other birth control pills.
What are the side effects/health risks of birth control pills?
In healthy women, oral contraceptives have few side effects. Nausea, breast tenderness, weight gain, changes in mood, and breakthrough bleeding are the most common ones -- and these usually diminish with continued use. Pregnancy is still possible. With proper use, though, that possibility is minimized. Oral contraceptives do not protect against HIV or other sexually transmitted infections.
The following symptoms may indicate serious -- even life-threatening -- side effects:
- Pain in the chest or abdomen
- Severe headache
- Blurry vision
- Pain and/or swelling in the legs or thighs
A woman who develops any of those symptoms should seek immediate medical attention.
Though oral contraceptives are usually well-tolerated in healthy women, there can be serious complications associated with their use. Some of the serious conditions include:
Central Nervous System
- Blood clot in the eye
- Benign and cancerous tumors of the liver
- Blood clot in the blood vessels that support the intestines
- Gallbladder disease
For women with previous health issues, birth control pills may be a poor choice for contraception. The biggest concern is the generation of blood clots, strokes, and heart attacks -- especially in women who are older and who smoke. In fact, women who smoke and take birth control pills dramatically increase their risk of developing strokes and heart attacks. The risk increases with age and amount of cigarette use. Birth control pills that contain estrogen may worsen diabetes.
Women who experience migraine headaches, particularly those over age 35 and those who experience migraines with visual symptoms, are also at increased risk of stroke when using oral contraceptives.
Other medical history items that would prohibit oral contraceptive use include:
There is some evidence that long-term use of birth control pills may increase the risk for cervical cancer. And while studies show a slightly higher risk for breast cancer in women who have used the pill, no conclusions have been reached. Oral contraception may increase liver cancer risk.
Oral contraceptives have been shown in studies to reduce the risk of ovarian and endometrial cancers.
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