Birth control pills contain synthetic versions of hormones called estrogen and progesterone. Sometimes, they contain both (combined pills) and others only contain one hormone (mini pills). Introducing additional hormones into the body can carry some risk. Taking contraception has the ability to cause side effects, and it’s not safe for everyone to take oral birth control. Each pill comes with a number of warnings and contraindications.
It is mainly for this reason that contraceptive pills are prescription-only medications (POM). It’s currently not possible to buy any birth control pills over the counter in the US. However, some states allow pharmacists to prescribe birth control pills, so you won’t need an additional doctor’s appointment.
Risks of hormonal contraception
Hormonal contraception has helped many women since it was first introduced in 1960, and roughly 98% of all women in the US will have used birth control at some point.
But hormonal contraception can also carry risks when taken, namely as side effects. Common side effects of hormonal contraception can include, but are not limited to, headaches, spotting or period changes, nausea, breast tenderness, weight gain, mood changes, decreased libido and vaginal discharge. Contraceptives which contain hormones as their active ingredients have an increased risk association with blood clots.
While contraception can be highly effective, as much as 99% with perfect use, there is always a small risk that an unintended pregnancy may occur while taking hormonal contraceptives.
Hormonal contraception also isn’t suitable for everyone to take. For example, contraception which contains estrogen cannot be taken by women who are over 35 and smoke, are very overweight and who take certain medications. For these women, the mini pill is likely a more suitable option as it only contains progestin but works just as well as the combined pill.
If you have certain health conditions, birth control may not be safe for you to take. For example, with reference to combined hormonal birth control, you should not take these if you have any of the following conditions:
- Migraines accompanied by aura
- Uncontrolled high blood pressure
- Smoke and have high blood pressure
- Liver tumor
- Unexplained vaginal bleeding
- Cancers affecting the breasts, vagina, cervix or uterus
Coronary artery disease
- History of stroke or heart attack
- Blood clots or history of blood clots.
Choosing the best contraceptive for you
Different hormonal contraceptives may be suitable for different people, and certain pills might be more preferable to you than others in terms of side effects.
Things to consider when thinking about contraception include:
- Whether they need to be taken daily
- Whether you’re prone to forgetfulness or not remembering
- Are you comfortable inserting something into your vagina?
- Do you mind if contraception impacts your period?
If you respond more adversely to hormonal contraception in terms of side effects, you might want to try “low-dose” contraceptives, which contain lower amounts of hormones than older, more traditional pills.
If you experience oestrogenic side effects, those caused by the introduction of synthetic estrogen, you might want to try the mini pill (which contains progestin only)
Monitoring your use
Particularly if you’re taking birth control for the first time, a doctor or prescriber will want to monitor how you respond to it and whether it still seems suitable after a certain period of time. They may ask questions about any side effects you’ve noticed and whether you feel comfortable to continue taking the particular contraceptive they prescribed. They may also check your blood pressure regularly.
If you could benefit from a different contraceptive, they may prescribe you something else.