Oral Contraceptive Pills

The long term effects of the Oral Contraceptive Pill (OCP) are wide ranging and extremely variable from woman to woman. While there are many different reasons for starting on OCPs from contraception to the medical treatment of polycystic ovaries, endometriosis, or severe emotional dysphoria, the decision needs to be taken seriously and the risks weighed out against the therapeutic benefits.  OCPs are about 99.5% effective against pregnancy and this is the most common reason a woman might want to chose this form of contraception. It is relatively convenient and cost effective with many insurances covering it as part of an individual health plan. OCPs can  greatly improve the symptoms of a woman who suffers from severe PMS, a condition called Pre-Menstrual Dysphoric Disorder or PMDD, and can also greatly reduce the pain and discomfort associated with ovarian cysts or endometrial growths. These advantages to OCPs should in no way be discounted in the patient who is greatly suffering. Because of the convenience many women quickly make the decision to use this type of birth control without fully weighing the potential risks and complications. It is also important to note that OCPs are most often not just one ingredient but actually combinations of different hormones whose ratios determine how they will work in the body and for which patients they will be best suited.

Some of the notable risks for women to consider when choosing OCPs are very quickly stated at the end of the commercials we see so often on television. In the fine print it states that one of the most common is an increased risk for blood clots and stroke. Taking OCPs can increase a young woman’s chance of having a stroke. In fact, women who have a history of migraine headache are actually several times more at risk for a stroke while on oral birth control pills. Women with migraine who smoke are even more of an at risk group.  The use of low dose estrogen pills has been found to reduce this risk somewhat. Additional risks are an increase rate of cardiovascular disease and a potential increase in the risk of breast cancer.

Another type of long term consequence to taking OCPs is the increased difficulty in becoming pregnant later in life. It does not seem that teenage girls are advised that once they stop the pill it could take up to six months to resume a normal/regular menstrual cycle and for many women it takes much longer. Some types of birth control can reduce the production of cervical mucus over time to the point where a woman suffers chronic vaginal dryness which can last up to 30 cycles after the cessation of OCP use. This puts the woman at greater risk for infections, STDs, and later for infertility when the time comes that she does wish to become pregnant.

Clearly the primary importance for teenagers is the prevention of pregnancy and there can be no doubt that the roll of contraception is very important up until the point of desiring a child. OCPs are some 6% more effective than barrier methods but only equal to a highly educated and highly motivated charting of Basil Body Temperature and Cervical Mucus. For many low income areas oral birth control may be the best option for women to take to prevent pregnancy no matter what the statistical risks. It would be prudent to simply educate women when they first begin taking OCPs so that later in life they can be more prepared for the potential difficulties they may experience when and if they desire to achieve pregnancy.



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