The use of birth control pills can lead to some side effects, such as an increased chance of cardiovascular disease. We explain what the risks are.
- What types of birth control pills are there and how do they work?
- Birth control pills and risk of cardiovascular disease
- Birth control pills and skin problems
- Birth control pills and cancer risk
- Other side effects of oral contraceptives
Among all contraceptive methods, pills are the second most chosen by Spanish women (only behind condoms). 17% take birth control pills, a figure that rises to about 28% among those aged 25 to 29, according to the Contraception Survey in Spain 2022 of the Spanish Society of Contraception.
Beyond their undoubted usefulness to avoid unwanted pregnancies, they also have some side effects that must be known.
WHAT TYPES OF BIRTH CONTROL PILLS ARE THERE AND HOW DO THEY WORK?
Currently, there are several types of birth control pills:
- Combined birth control pills.
- Birth control pills only with gestagens.
Both work by preventing ovulation. Combined birth control pills are the most prescribed and are composed of two hormones similar to those produced by the female ovary: estrogen and progesterone. On the one hand, estrogen regulates the cycle and establishes a pattern of regular bleeding and, on the other, progesterone prevents the ovary from ovulating, thus eliminating the likelihood of pregnancy.
Gestagen-only pills also prevent ovulation, but, as they do not contain estrogen, bleeding is not regular.
BIRTH CONTROL PILLS: SIDE EFFECTS
BIRTH CONTROL PILLS AND RISK OF CARDIOVASCULAR DISEASE
Although it is true that the birth control pills currently used have a much lower hormonal dose than the first ones that were created and, therefore, fewer adverse effects, there are still risks.
Combined contraceptives, as we have mentioned, base their effect on the combined action of estrogens and gestagens (progesterone). These hormones have the ability to induce changes in metabolism and increase the risk of cardiovascular disease.
The mechanism by which these pills can increase this risk involves the action of estrogen on the hemostatic system (responsible for preventing blood loss and maintaining circulatory fluidity), that of gestogen on lipid metabolism (such as cholesterol or triglycerides) and the combined action of both on carbohydrate metabolism and blood pressure.
As indicated by the Spanish Heart Foundation, they increase the risk of coronary heart disease, hypertension, venous thrombosis and pulmonary embolisms, especially when there are other associated blood disorders.
Combined contraceptive pills are contraindicated in women with a history of strokes or strokes and in smokers over 35 years of age and are also not appropriate for those with hypertension.
BIRTH CONTROL PILLS AND SKIN PROBLEMS
In women with a history of hereditary angioedema, combination birth control pills may induce or increase angioedema symptoms.
They can also cause chloasma (i.e., dark spots on the forehead, cheeks, or upper lip), especially in those women with a history of chloasma during pregnancy. If you have a tendency to develop these spots and contraceptive intakes, it is recommended to avoid exposure to ultraviolet radiation and the sun.
BIRTH CONTROL PILLS AND CANCER RISK
Birth control pills have also been linked to different types of cancers, mainly gynecological.
Some studies have associated the use of oral contraceptives with an increased risk of breast cancer. However, the evidence is inconclusive because studies that have investigated this association are observational and it cannot be ruled out that factors beyond the use of birth control pills influence the results. In any case, larger studies that have found an association indicate a slight increased risk.
- What is clear is that in women with breast cancer the use of contraceptive pills is contraindicated.
With regard to cervical (cervix) cancer, studies suggest that there is an association between birth control pills and an increased risk of invasive cancer and intraepithelial neoplasia. This risk would increase with the length of time of use of these pills (more than 5 years) and does not persist after stopping treatment.
OTHER SIDE EFFECTS OF ORAL CONTRACEPTIVE PILLS
Other side effects of birth control pills include menstrual cycle disturbances (i.e., breakthrough bleeding, amenorrhea), headaches, tightness or tenderness in the breasts, nausea, increased vaginal discharge or decreased libido. However, most of these side effects are mild and may go away when switching birth control pills.
Side effects that were more common with first-generation contraceptives but now occur are acne, hair gain (hirsutism) and weight gain.
On the other hand, if you are taking medication, you should always consult your doctor because it could affect its functioning or decrease the effectiveness of contraceptives.
