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The Long-Term Side Effects of Birth Control Pills: Should You Be Scared?

Evidence-based Reviewed Article

An image of brown and white pills with white flowers in the backgroundBirth control pills were first introduced to women in the USA in the 1960s.1 Proven a highly effective form of birth control, the pill has meant that women can better practice family planning. This means that it has enabled women not only in the USA, but globally, to further their careers and decide when they would start a family. Yet this does not mean that the use of contraceptives does not have certain drawbacks, especially regarding their safety. This has led to many studies on the long-term side effects of birth control pills. We will look at a few of these safety considerations.

The Makeup of Birth Control Pills

Most birth control pills consist of manufactured progesterone and estrogen. We refer to these as combination pills. They work in two ways.

Firstly, they prevent ovulation or the release of an egg during a woman’s monthly cycle. A woman cannot fall pregnant if her body does not release an egg for fertilization by a man’s sperm.

Secondly, birth control pills thicken the mucus around a woman’s cervix. In doing so, it makes it extremely difficult for sperm to reach the uterus and fertilize any released eggs.

Another type of birth control is the mini pill. This refers to a low-dose progesterone-only pill. Although it works in a similar way as the combination pill, it is less effective in preventing pregnancy.

You should take a birth control pill at the same time every day. This is regardless of whether you use the mini pill or the combination pill. Doing so improves its effectiveness as a means of birth control.

The Long-Term Side Effect of Birth Control Pills: Your Benefits and Risks

Before we discuss the downsides of birth control pills, it is worth noting that they do offer certain benefits.

Benefits of Birth Control Pills

One of the positive long-term side effects of birth control pills is that they may increase your iron levels. This may result from the decrease in menstrual flow often experienced when taking them.

Research also points to an initially decreased risk of developing breast cancer and ovarian cysts. You may also have a reduced risk of uterine fibroids. This reduced risk may increase the longer you use birth control pills.

Using birth control pills may also reduce the risk of pelvic inflammatory disease. This condition is a major cause of infertility in females.

Taking oral contraceptives may also reduce your risk of developing an ectopic pregnancy, endometrial cancer, and uterine cancer.

The Long-Term Side Effects of Birth Control Pills

However, many studies have confirmed that long-term side effects of birth control pills exist. Possible side effects include an increased risk of the following in women:

  • Cardiovascular disease: venous thromboembolism, myocardial infarction, and stroke
  • Metabolic issues: increased HDL cholesterol in the blood and a decreased glucose intolerance
  • Neoplastic diseases, or conditions resulting in tumor growth, whether benign or cancerous: breast cancer, cervical cancer, and even possibly liver cancer, amongst various others
  • An increased susceptibility to gallbladder disease
  • Behavioral health: increased mood swings or possible depression

Meningioma Tumors

An image of a brain scanAs mentioned, one of the potential long-term side effects of birth control pills is tumors. One of these is meningioma. This is a type of brain tumor. Most meningiomas are non-cancerous.

Found in the tissues surrounding the brain, your risk of developing this type of tumor increases if you use birth control pills for more than a year. However, the risk of developing this type of tumor is relatively small and rarely life-threatening. Progesterone in oral contraceptives causes this risk.

The most common type of tumor forming in the head, a meningioma is not a brain tumor. It develops in the tissue outside the brain, more specifically the membranes surrounding the brain and spinal cord. This type of tumor grows slowly. It may take years before any symptoms manifest. The symptoms, however, can have serious consequences.

Most commonly found in women, meningioma can develop at any age, although it is mostly found in older women.3  The most common symptoms of this type of tumor include:

  • Memory loss
  • Headaches
  • Vision issues, e.g., blurring or seeing double
  • Seizures
  • Issues with speaking properly
  • Loss of smell
  • Hearing loss
  • Ringing in the ears
  • Arm and leg weakness

Although these symptoms usually take a long time to develop, you should see a healthcare provider if they suddenly appear.

The Long-Term Side Effects of Birth Control Pills with Adrenal Fatigue

Your uterus, ovaries, and breasts form part of the endocrine system. Any factors that affect your hormones thus affect them as well. At the same time, however, these hormonal changes may also affect your Neuroaffect Circuit because it depends on chemical messengers, which are often hormones, to work effectively. Both circuits form part of your body’s NeuroEndoMetabolic (NEM) stress response apparatus.

Prolonged stress may cause a prolonged NEM stress response that could result in Adrenal Fatigue. Adrenal Fatigue occurs when stress causes an increased cortisol production over an extended period. It is a condition where the body is unable to keep up with long-term stress, resulting in various nonspecific symptoms such as tiredness, sleep disturbances, hormone imbalances, reproductive issues, and weight gain. Your adrenal glands may wear out and no longer be able to produce the elevated cortisol levels needed. The condition is often associated with hormonal and brain health issues. The hormones found in oral contraceptives, estrogen and progesterone, are two of these hormones.

Both of the hormones commonly found in oral contraceptives play a role in brain health. This implies the long-term side effects of birth control pills play a role in brain health as well.

Estrogen

Estrogen plays a role in the growth and repair of neurons as well as the production of nerve growth factors. This includes those found in the brain. As a result, this hormone may play a role in determining mood, emotions, and proper cognitive function. This is often why women see changes in these areas during menopause. Estrogen levels decline during this period of life.

Estrogen dominance may occur when you suffer from Adrenal Fatigue. This is because your body will use progesterone to manufacture cortisol when the adrenals can no longer manufacture enough cortisol to meet the demand. This means that your estrogen levels are higher than your progesterone levels.

Birth control pills can also cause estrogen dominance when taken in high doses because they can influence the body’s production of natural hormones.

Progesterone

Progesterone plays an important role in brain health. It:

  • An image of a blackboard with progesterone and it's chemical composition written in itPlays a role in forming nerve cell connections
  • Acts as a behavior regulator
  • Reduces your susceptibility to seizures
  • Plays a role in growing and developing the tissue of the nervous system
  • Helps repair damaged brain cells
  • Promotes cognitive ability
  • Plays a role regarding mood and how you respond to stress, anxiety, and depression
  • Fights inflammation

Your progesterone levels, like your estrogen levels, tend to decline during menopause.

However, stress, the number one cause of adrenal fatigue, increases cortisol production in the adrenal glands. Progesterone, however, is the precursor hormone to cortisol. You will thus see a sharp decline in progesterone levels when your cortisol levels increase.

Natural Birth Control Options to Avoid The Long-Term Side Effects of Birth Control Pills

Natural birth control refers to a form of birth control that does not involve the use of birth control pills or intrauterine devices (IUD). It can lead to few or no side effects, but it is also less effective. This method of family planning involves keeping track of your fertility, i.e., when you ovulate.

Please talk to your healthcare provider about these natural family planning alternatives before you start, as they can best advise you on how they work and how to minimize your risk of pregnancy.

Natural Family Planning

Natural family planning refers to 100% natural methods of staving off a pregnancy. Please note that no family planning method, including the pill, has a 100% success rate.

Lactational Amenorrhea Method

This natural family planning method only works if you have had a baby, breastfed immediately, and have had no period.

Women who breastfeed their babies may only start their periods once they stop breastfeeding or after the baby is a year or two old. They do not ovulate while breastfeeding. You can only get pregnant if you ovulate.

Yet you need to meet certain criteria for this method to be a possibility for you. The method also only works for the first six months after you have given birth. The criteria include breastfeeding at least every four hours during the day and at least every six hours at night. This method may prove less effective once you start feeding your baby solid food.

Rhythm Method

One of the oldest ways to prevent a pregnancy, this method relies on the calendar. Most women's menstrual cycle lasts for 23 to 32 days, around 28 on average. Ovulation usually takes place around the 14th day. This is when your fertility is at its highest.  You would thus not have sex for five or more days preceding and post ovulation. Your healthcare practitioner can help you work out your ovulation calendar. They are best suited to help you with this because each woman’s menstrual cycle may differ.

This method does not work for everyone. For example, ovulation may not occur on the 14th day if you have an irregular menstrual cycle.

BBT Method

The basal body temperature (BBT) method refers to tracking your body temperature to determine ovulation. Your body temperature can rise by one degree Fahrenheit when ovulation occurs and stay at this temperature until you have your period. For this method to work, you would need to take your temperature the moment you wake up in the morning and on an empty stomach.

This method is deemed unreliable by many because ovulation has already occurred after your temperature rises. This method may work if you only have sex after ovulation and before your period starts.

Ovulation Method

An image of a hand pointing at a calendar using a thermometer and a pregnancy test kitThis method sees you take regular note of your vaginal discharge. Your mucus looks and acts very much like raw egg whites when you ovulate. You would need to constantly note the character of your mucus daily to know when ovulation has taken place.

Condoms

Condoms form a barrier that does not allow sperm to pass. Most people are quite familiar with male condoms which are put onto the penis before penetration. Condoms for women also exist, however. Both male and female condoms are made of latex or polyurethane.

A female condom fits inside the vagina and fits over the cervix.

Considered a relatively safe option for birth control, please note that some people may have latex or polyurethane sensitivities.

Vaginal Gel

Phexxi is a vaginal gel available on prescription that is a contraceptive to be used prior to sex. It contains no hormones. Neither is it a spermicide. Instead, it lowers your vaginal pH and thus reduces a sperm cell’s ability to move. This reduces the chances of pregnancy.

In Closing

Oral contraceptives may have potential benefits. Yet there are also potential long-term side effects of birth control pills to consider before deciding whether you should use them or not. However, there are various other methods of natural birth control. While not as easy or effective in many cases as popping a pill, they can be effective if you follow them correctly. Please give us a call at +1 (626) 571-1234 if you have further questions about hormone balancing or adrenal fatigue.

© Copyright 2024 Michael Lam, M.D. All Rights Reserved.
References

Tyrer, L. “Introduction of the Pill and Its Impact.” Contraception, vol. 59, no. 1 Suppl, Jan. 1999, pp. 11S-16S, https://doi.org/10.1016/s0010-7824(98)00131-0.

“Contraceptive Benefits and Risks.” Contraception and Reproduction - NCBI Bookshelf, 1989, https://ncbi.nlm.nih.gov/books/NBK235069/.

Haider, S., et al. “Health-Related Quality of Life in Meningioma.” Neuro-Oncology Advances, vol. 3, no. 1, 26 June 2021, p. vdab089, https://doi.org/10.1093/noajnl/vdab089.

Dr. Lam’s Key Question

The long-term side effects of birth control pills include cardiovascular disease, metabolic issues, and neoplastic diseases. The latter includes various forms of tumors and cancers. They may also have an effect on adrenal health. Your healthcare provider can suggest safer alternatives.

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