What you need to know.
Show of hands if you’ve been taking the birth control pill for over a decade. Do the math—it’s probably true. Kind of scary, right? Especially because you probably haven’t thought twice about it since taking your first pill on the cusp of your teenage years. And if you’re an average woman in good health, it’s probably the one consistent medication you’ve taken for longer than a week. So here are the questions: what do you really know about the pill? What does it actually do to your body? Is it healthy, considering your daily (and subsequently years-long) intake? Is the pill the best form of contraception available, like we’ve thought for so long? We reached out to women’s health expert, Dr. Christine Palmay, to answer all our questions. Do yourself a favor and read the below.
How it Works
“The birth control pill prevents pregnancy by working at the level of ovulation. Through suppression of a complex hormonal axis, the pill prevents the release of an egg from the ovaries and thus prevents the possibility of pregnancy. Secondary mechanisms of action include increasing cervical mucus (to impede sperm) and also changing the endometrium (lining of the uterus) to impede implantation.”
“If you’re at risk of a thromboembolic event (DVT or stroke) due to genetic factors or lifestyle factors like smoking, any form of the birth control pill may not be for you. I worry that many young patients are not properly screened for those risk factors.
“Hormonal birth control is a medication and as such, it comes with risks and side effects to consider. It’s essential to note that not all women should be prescribed hormones. Factors such as risk of blood clots, migraines, smoking status, and breast cancer risk are all issues that I discuss with my patients during birth control counseling sessions. Women who have contraindications to using hormones should use other options, but they represent a small portion of my patients. Likewise, side effects such as weight gain, nausea, and mood fluctuations may occur. Talk to your healthcare provider, who can make recommendations to switch your birth control choice if you have side effects. Know that one form of birth control is not ideal for every woman and side effects can be minimized or prevented by ensuring that you have the right match.”
Are There Long-Term Effects?
“This question addresses the idea that long-term use of the pill leading to infertility. As a doctor who has a young female practice, I’m constantly asked if being on hormones for a long duration will affect future fertility. Understandably, wanting to have a child is a huge area of concern, but hormonal birth control does not affect fertility in the least. Speak to your healthcare provider about your fertility questions and to recommend when to stop birth control prior to trying to conceive.”
The Importance of Consistency
“Many of my patients have admitted to stopping their birth control for weeks at a time because they either ran out of medications, forgot to restart a pack of pills/reinsert a ring or simply wanted time off. It’s important to remember that any hormonal form of birth control generally takes three months to stabilize. During this time period, side effects such as breakthrough bleeding or nausea may occur. Most significantly, the efficacy of any birth control option in preventing pregnancy decreases with inconsistent use. I do not recommend starting and stopping.
“One of the most significant causes of an unintended pregnancy in women who take the pill is compliance. Missing even a single pill or taking a pill late can drastically reduce the effectiveness of the pill. If you are concerned, contact your family doctor regarding protocols for missed pills. Likewise, if you seem to be taking your pills inconsistently, seek out other alternatives that may be better suited for your lifestyle.”