The Pros and Cons of the Birth Control Pill

Women have been enjoying the benefits of the birth control pill since the first one was approved by the Food and Drug Administration (FDA) on May 9, 1960. When used as directed, the pill is 99% effective in preventing pregnancy.

Most women can safely use birth control pills. However, as with all medications, they do have possible side effects and risks.

Here's a rundown of the pros and cons of using oral contraceptives, including common side effects.

Pros of the Birth Control Pill

Obviously, the main reasons to take the birth control pill are to prevent pregnancy and regulate the menstrual cycle. Some of the pill's benefits include:

• It is a very convenient and safe method of contraception.
• It allows for sexual spontaneity (so you don't have to plan in advance).
• It can lead to lighter periods.
• It can decrease the discomfort of menstrual cramps.
• Combination pills can be taken to change the timing and frequency of your period or to skip your period altogether.

Other Benefits

Combination birth control pills that include both estrogen and progestin can also provide other health benefits. They may offer some protection against:

• Ovarian cancer
• Endometrial cancer
• Uterine fibroids
• Symptoms of endometriosis
• Heavy menstrual bleeding
• Polycystic ovary syndrome
• Acne
• Migraines

Cancer Protection and the Pill

Research suggests that birth control pills can lower the risk of ovarian cancer by 27% and the risk of endometrial cancer by 50% compared to other types of contraceptives.

Protection against developing these cancers can last up to 30 years after stopping combination birth control pills. Plus, protection increases with each year of use.

Studies also show that women who take the pill are 15% to 20% less likely to get colorectal cancer.

Cons of the Birth Control Pill

If you use birth control pills, you may experience some side effects. The good news is that most of these side effects will go away by the second or third month of use as your body adjusts to the hormones in the pill.

Birth control pill side effects may include:

• Headaches
• Breast tenderness
• Nausea (sometimes with vomiting)
• Bleeding between periods

Combination birth control pills may also cause:

• Depression
• Changes in libido (sexual desire)

Progestin-only birth control pills may lead to irregular spotting and bleeding more frequently than combination pills.

Managing Side Effects

You should read the paper insert that comes inside your pill pack for more detailed information about how to use them and what the side effects are. The insert should also explain when to take your birth control pills and what to do if you miss a pill.

You can take your birth control pill with an evening meal or at bedtime to help decrease nausea and/or vomiting.

Side effects are a common reason why people stop taking birth control pills. Talk to your healthcare provider to see if changing to a different brand of pill may help, especially if the side effects last longer than a few months.

Risks and Complications

Serious problems do not occur very often with the pill.

The most serious potential complication of combination birth control pill is developing a blood clot in your lungs or legs.

The risk is increased in:

• Women who smoke
• Women age 35 or older
• Women who have high cholesterol, high blood pressure, diabetes, and conditions that increase the risk of blood clotting
• Women who are confined to bed rest or are wearing a cast
  

If you have a history of depression, you may not be able to continue to take birth control pills if your depression worsens.

Certain medications can lower the pill's effectiveness. Therefore, always tell your healthcare provider about any medications you are taking when discussing the pill. Once you are on the pill, always include the brand you are taking when you are asked for a list of your medications.

Pill brands like Yaz and Beyaz contain drospirenone. These pills may have an interaction with medications that increase potassium, such as angiotensin-converting enzyme (ACE) inhibitors and beta blockers. Potassium is a mineral in your blood that helps regulate your heartbeat and blood pressure, among other things.

Alternatives to the Pill

If you and your healthcare provider determine that the pill is not right for you, there are several other birth control methods available.

Birth control methods can be divided into five categories:

Natural rhythm methods: Also known as natural family planning, the natural rhythm method entails identifying when a person is ovulating by tracking their menstrual cycle then avoiding sexual intercourse on those fertile days. Fertility journals and menstrual cycle tracking apps can be especially helpful with the natural rhythm method.

Barrier methods: Condoms, diaphragms, sponges, and cervical caps are all forms of barrier methods that can be used by themselves or as a second, backup method in case the pill, intrauterine device (IUD), or natural rhythm method fail. Barrier methods are used each time you have sex then removed afterwards.

Short-acting hormonal methods: The birth control pill falls under this category, along with the patch, contraceptive injection, and vaginal ring. Since these methods involve hormone regulation, you will need a prescription to get one. Some, like the pill and vaginal ring, are used every day for three weeks at a time, while others, like injections, are taken once every eight weeks.

Long-acting reversible methods: Longer-term methods, like IUDs and hormonal implants, are inserted once then left alone for three to 10 years (depending on the method) until they need to be removed. The 100% hormone-free ParaGard copper IUD is also available and lasts for 10 years.

Sterilization: Biological female sterilization entails "tying off" the fallopian tubes (tubal ligation) or creating a natural barrier within them (tubal occlusion). For biological males, a vasectomy stops sperm from getting into a male's ejaculated semen. Each of these surgical procedures last for a lifetime, although they can be reversed with separate procedures.

Summary

Birth control pills are 99% effective in preventing pregnancy when used as directed. Birth control pills have other health benefits. They can lessen the pain of menstrual cramps, keep acne under control, and protect against certain cancers.

As with all medications, they do have some potential risks and side effects. These include an increased risk of blood clots and a small increase in breast cancer risk.

You and your healthcare provider should discuss the pros and cons of the pill for you specifically. It can take a few months for side effects to go away completely. If you continue to have side effects, your doctor may want you to switch to a different brand. It may take some trial and error with various pill brands until you find the brand that works best with your body.