The oral contraceptive pill is the most popular type of birth control among Australian women . In fact, between 50-80% of us will use it at some stage in our lives.
This once-daily pill is both affordable and effective, using hormones to stop ovulation, thicken the mucus on the cervix, and block fertilisation.
As far as preventing pregnancy goes, the birth control pill is one of the easiest methods to follow (as long as it’s taken correctly). But is it safe to take it as a long-term contraceptive method? Let's dive into it.
What are the side effects of the pill?
Although they aren’t incredibly serious and are typically temporary, there are a few potential side effects of the contraceptive pill:
- Irregular bleeding or spotting (often between periods)
- Sore or tender breasts
- Changes to your skin
- Mood changes
- Weight gain
Usually, these uncomfortable side effects ease after 2-3 months and the severity of these symptoms will differ from woman to woman.
However, they can be managed by changing your particular dosage (such as moving to progestogen-only prescriptions) as well as exploring other options of contraception (such as contraceptive implants or non-hormonal copper intrauterine devices).
Make sure to speak with a GP before changing your birth control to discuss what option might be best for you.
Taking birth control pills long-term: Is it safe?
For those who haven’t experienced adverse side effects, continued usage of the pill in the long term might be an attractive option.
In most cases, long-term use of the pill is safe, though it is important to check in with your GP on a regular basis to ensure this remains a safe choice both now and in the years to come.
There are, however, a few exceptions to this.
For smokers (particularly those over the age of 35), the combined pill should not be used as a form of contraception, because it contains the hormone oestrogen, which can increase the risk of blood clots and heart attacks for smokers.
Plus, this risk is also heightened for women with high blood pressure, a history of heart disease, and diabetes.
As a long-term birth control option, the pill’s effectiveness is dependent on whether it continues to suit your needs and lifestyle.
Additionally, the pill is only most effective with consistent use, which means missing doses regularly can increase your chances of unwanted pregnancy. If you’re struggling to remember to take your tablets daily, it might be wise to consider other hormonal or non-hormonal contraception options, too.
Remember, all of us have different experiences on the pill. Seeking personalised advice from your doctor or GP will help you make an informed decision based on your own circumstances.
Are there any serious side effects of long-term usage?
Along with the common side effects, there are also cases of more serious implications of long-term usage of the pill . Although these health risks are rare, it's still important to be aware of them.
A small increase in the risk of venous thromboembolism (the disease that causes deep vein thrombosis, or DVT) has been linked to the pill .
Studies have shown a 3-fold risk increase in DVT during pill usage in comparison to non-users .
However, this is still lower than the risk women experience during pregnancy and the immediate period after giving birth. That's why for new mothers, using the combined pill is not recommended within 3 weeks of delivery — because their risk of DVT is heightened immediately after childbirth .
There is also a low chance of increased risk of arterial disease (such as myocardial infarction and ischaemic stroke) .
This is usually very low with between 2-20 per million women affected depending on age. Those with a history of arterial disease, obesity, smoking, migraines with aura, diabetes with vascular complications, or uncontrolled hypertension should look for other contraception options.
There has been a lot of debate about the link between oral contraceptives and cancer . Two recent UK studies have noted that the pill isn’t connected with an overall increased risk of cancer. In fact, they’ve found some positive stats when it comes to long-term usage of the medication.
The combination pill reduces the risk of uterine (in particular, endometrial) and ovarian cancers, with women who took the pill for 3 years seeing a 50% reduction in their risk of developing these cancers (reaching an 80% reduction for those taking the pill for 10 years or more) .
Plus, these protective effects are said to last for at least 20 years after stopping the pill.
We should mention, however, that studies have found a small increase in the risk of cervical cancer among long-term users of the pill (over 5 years of continued usage) . The level of risk is shown to elevate with duration (meaning the longer you take the pill, the higher your level of risk) but, interestingly, once a woman stops taking the pill her level of risk returns back to normal levels.
Other research has also shown a link between the pill and breast cancer, suggesting a slight increase in risk for women who are on the pill for more than 5 years. But ultimately, this risk is still small, going from about 1 time higher to 1.6 times higher .
Finally, women with a history of liver cancer are not advised to take the combined oral contraceptive pill, as research has revealed a 4-fold increase in the risk of liver cancer among long-term users .
What about skipping the sugar pills?
When you're on the pill, you may notice that your menstrual cycle changes. And if we're being honest, having no periods sounds like a pretty brilliant idea. But is it safe to ditch the inactive pills entirely and only take hormone pills?
Using the pill continuously (i.e. never having your period) is shown to be completely safe and won’t cause long-term issues .
In fact, women who experience painful periods or severe menstrual systems (such as seizures, dizziness, asthma, headaches or mood disturbances) may be advised by their doctors to do so.
Keep in mind, however, that taking the pill continuously can increase the chances of breakthrough bleeding (or spotting) that can last for 2-3 days.
If you notice moderate or even heavy bleeding that lasts more than 4 days, stopping birth control pills for 4 days can be a wise strategy to allow your body to experience a normal period. After that time, you can recommence taking the medication as usual.
If you’re unsure about your symptoms while taking the pill continuously, your GP will be able to advise the best approach for your situation.
As you can probably tell, there’s no one-size-fits-all approach to birth control and sticking to the same type of contraceptive as we age isn’t always the smartest (or safest) option. If you're planning to use the pill over the long term, it’s important to keep in touch with your GP to ensure this option is still suitable for you.
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