The introduction of “the pill” in 1960 gave women the power to control their fertility. This was a historical moment. Over 80% of women born after 1945 have used the pill at some point in their lives. The other power this pill provides is the control over menstruation which is sometimes the primary reason its use. This is indeed a true medical marvel but it’s not perfect.

As with all medications, there are potential risks associated with the pill use. These include:
• Thromboembolic events such as heart attacks, stroke and blood clots in the deep veins and other vessels: this is the major risk and it gradually increases with age
• Breast cancer (risk only slightly increased)
• Hepatic cancer and noncancerous tumors of the liver (rare)
• Increase in the serum lipids (elevated cholesterol)

In some women, their age, health status, and habits might contribute to an even higher risk of problems on the pill. The situations where the pill is contraindicated include:
• Heavy smoking of cigarettes and over age 35: the risk of a thromboembolic event is increased by 4 fold compared to a woman over 35 who doesn’t smoke
• Thromboembolic disorders or a history of a thromboembolic event
• Severe hypertension
• Kidney, Liver or Adrenal dysfunction
• Diabetes with vascular involvement
• Breast Cancer
• Endometrial Cancer or other estrogen dependent cancer
• Other conditions that might increase the risk of clotting

There are many benefits to taking the birth control pills. They include:
• Effective birth control (>99% effective)
• Regulates menstrual cycle in those with heavy or irregular periods
• Relieves the pain (cramps) that occur with menstruation
• Treats endometriosis
• Prevents recurrent ovarian cyst
• Decreases the risk of Ovarian Cancer and Endometrial Cancer
• Treats Premenstrual Syndrome and Premenstrual Dysphoric Disorder
• Certain types are helpful for acne
• Can use to regulate the onset of menses and decrease the frequency of menstruation

Not everyone tolerates the pill. Side effects or medication intolerance are the major reasons for discontinuation. Common side effects and other pill problems include:
• Spotting and irregular or heavy bleeding
• Nausea/vomiting
• Breast tenderness
• Difficulty remembering to take the pill daily

The birth control pill is an excellent option for effective, reversible contraception. It also provides effective treatment for many gynecologic disorders and relief of menstrual related problems such as heavy painful periods. As with all medications, it has its risk and is not the right choice for every woman. It doesn’t prevent the transmission of sexually acquired infections and can contribute to major problems if used incorrectly. It is important to be knowledgeable about all of your contraceptive options and partner with you health care provider to choose the one that is right for you.