Birth control pills: The risks and benefits of taking oral contraception

FILE -- Oral contraceptives are a popular and effective way to prevent pregnancy, but there are also a lot of questions surrounding the pill. Photo by: BSIP/UIG via Getty Images

When the birth control pill was approved by the FDA in 1960, it launched an international revolution of women to be in power of their own sexual and reproductive decisions.

Oral contraceptives are one of the most frequently used prescribed medications by Canadian women, according to Statistics Canada, but there are still a lot of questions surrounding them.

READ MORE: Birth control and vitamin D, what women trying to get pregnant should know

Not only are there different types of birth control but everyone’s body can react differently when taking it. Here is everything you need to know about the pill.

How do birth control pills work?

Birth control pills stop your body from ovulating. The hormones in the pill prevent your eggs from leaving your ovaries, meaning sperm cannot fertilize them.

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The pill’s hormones also thicken the mucus on the cervix. Thicker cervical mucus makes it hard for the sperm to swim to an egg — almost like a sticky security guard.

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If you take it the way its directed (i.e. every day at the same time), it has a 92 per cent efficacy rate, according to Dr. Elisa Assadi, a Vancouver-based family physician with Copeman Healthcare.

Keep in mind that some medication, like antibiotics, can make the pill less effective.

What are the different types of birth control?

Combination pills

Combination birth control pills contain forms of the hormones estrogen and progestin.

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Progestin-only pills

Progestin-only pills contain progestin without estrogen. This type of pill is also called the minipill. Progestin-only pills may be a good choice for women who can’t take estrogen for health or other reasons.

What are the benefits of taking it?

The most basic benefit when taking the pill is preventing pregnancy. But there are other advantages as well.

“You may experience less cramping, less bleeding, periods are more predictable and you may notice an improvement in acne,” Assadi said.

Taking the pill also decreases your risk of ovarian and endometrial cancers, she added.

A study released in March 2017 by the University of Aberdeen suggests that while there is a slight risk in developing breast and cervical cancers, the birth control pill might have a “strong preventative effect” for staving off ovarian, endometrial and bowel cancers for up to three decades.

What are the risks?

The pill does come with some potential negative side effects. Short-term risks include spotting, breast tenderness, nausea, vomiting and bloating — but this typically stops after the first couple months of taking it.

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Birth control pills also don’t protect against sexually transmitted infections.

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Some long-term consequences include an increased risk of blood clots, particularly if you are a heavy smoker and over the age of 35, Assadi said. Complications (although rare) can also include heart attacks, stroke, increased blood pressure and liver tumours.

Research has linked an increased risk of depression to not just the pill, but other forms of birth control such as the patch and IUD.

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A  13-year research project out of Denmark, published in JAMA Psychiatry, found women who used hormonal contraception were found to have a 40 per cent greater chance of developing depression after six months of use, compared to those who didn’t use it.

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“The potential risks are there and are some indication of why a doctor would not recommend [birth control pills] for every woman,” she said.

If you have any concerns, you should talk to your doctor.

What happens when you take the pill long-term?

One common concern about long-term use of birth control pills is how it affects your cancer risk.

“There is a slight increased risk of breast cancer and cervical cancer. And these risks depend on the length of time you are on [it],” Assadi said.

If these cancers run in your family, be sure to tell your doctor and discuss your risks.

What happens if you stop taking it?

You can stop taking the pill whenever you want. It may take a few months for your periods to return to the cycle you had before you started using it.

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But once you stop taking the pill, it is possible to get pregnant.

What happens if your birth control is recalled or defective?

Recalls and defects for the pill happen. In February, Apotex Inc. recalled a batch of Alysena 28 birth control pills. The company said they may not be effective in preventing pregnancy because the pills were chipped.

If your birth control pills are a part of the recall, you should notify your doctor and return the product to the pharmacy.

What are alternative ways to prevent pregnancy?

If you are looking for an alternative birth control option, there are several choices.

One of the most popular options is the intrauterine device (IUD), which is 99.2 per cent to 99.9 per cent effective at preventing pregnancy, Assadi said. It can also remain in your body for three to five years, so you don’t have to worry about taking a pill every day.

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“IUDs don’t get enough attention,” she said. “They are the revolution of contraception of our generation and a great option as long as you are a good candidate.”

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Then there are male and female condoms, the patch, the birth control shot or birth control ring.

If you’re looking at more natural options, you can try fertility awareness (tracking your ovulation) or withdrawal (but these methods are less effective at preventing pregnancy).

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