Understanding Birth Control Risks

Birth control is widely considered safe and effective, but like any medication, it carries potential health risks. While most side effects are mild, some complications can be serious especially with certain types of hormonal contraceptives. Being aware of these risks can help you make informed choices with your healthcare provider.

1. Blood Clots

Combination birth control pills containing estrogen may slightly increase the risk of developing blood clots. While rare, clots can become life-threatening if they travel to the brain, lungs, or heart.

Risk factors include:

• Being over 40

• Smoking

• Obesity

• Family history of clotting disorders

Progestin-only pills generally don’t carry this risk, and levonorgestrel-containing pills have among the lowest clot risk in their category.

2. Heart Disease and Stroke

Hormonal birth control may slightly raise the risk of ischemic stroke and heart attack, particularly with higher estrogen doses and longer use.

Higher risk if you:

• Smoke

• Have high blood pressure, diabetes, or high cholesterol

• Experience migraines with aura

Progestin-only options have little to no effect on heart attack or stroke risk and don’t typically impact blood pressure or cholesterol.

3. Increased Risk of Certain Cancers

Some research links hormonal contraceptives to a slightly higher risk of breast cancer, with risk potentially varying by tumor type, and to cervical cancer. Results are mixed, and the potential risk needs to be weighed against benefits, including reduced risks for ovarian and endometrial cancers.

4. Migraines

The World Health Organization advises avoiding estrogen-containing contraceptives if you:

• Are over 35 and experience migraines

• Have migraines with aura at any age

For menstrual migraines without aura, some combination pills may actually help reduce frequency.

5. Gallbladder Disease

While most oral contraceptives don’t raise gallbladder disease risk, other hormonal methods like Depo-Provera injections or levonorgestrel IUDs may. Rarely, oral contraceptives can contribute to benign liver tumors (hepatocellular adenomas) that sometimes affect the gallbladder.

Mild, Common Side Effects

Many people experience less serious side effects that may fade over time:

• Headaches

• Nausea

• Breast tenderness

• Spotting between periods

• Mood changes

• Decreased libido

Bottom line

Most people can take birth control safely, but factors like smoking, age, migraine history, and other health conditions can increase certain risks. Discuss your medical history and any concerns with your healthcare provider before starting or switching contraceptives.

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