Are birth control pills safe?

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Q: I’ve seen some scary things about birth control pills in the news lately.  Are they safe to take?

A: Birth control pills are a very popular method of contraception – the CDC reports that since 1945, 80% of women in the United States have used them at some point in their lives.  They are generally a very low risk medication – especially for young, healthy women – but low risk does not equal no risk.  Here’s what you need to know: 

Blood Clots

Many birth control pills contain estrogen, a hormone that makes your blood more likely to clot up.  A blood clot is a good thing when it stops a cut from bleeding, but it’s a very bad thing when it happens in the deep veins of your leg (DVT) or your lung (Pulmonary Embolus).  Fortunately, pills today contain a lot less estrogen than they used to, but taking any form of birth control (pill, ring, patch) containing estrogen can still mean a 3-6 times increased risk of blood clots, especially in women who are obese.

Heart Attack

Heart attacks and strokes are so rare in young, healthy women that there is not a significant risk of these conditions with the use of low-dose estrogen pills.  Certain conditions can increase that risk – high blood pressure, diabetes, certain types of migraines and smoking – so be sure to tell your health care provider if any of them apply to you. 

High Blood Pressure

About 1% of women develop hypertension when they start taking birth control pills.  High blood pressure is associated with an increased risk for heart disease, stroke, and kidney disease so it’s important to get regular checkups while you’re on the pill. 

Liver Disease

Although rare, birth control pills can cause benign tumors of the liver. This usually happens after 4-8 years of use.  High-dose estrogen pills have also been associated with an increased risk of gall bladder inflammation.

So how can you tell if you’re experiencing any of these side effects?  Just remember ACHES.

  • Abdominal pain that is severe. 
  • Chest pain that is severe or associated with shortness of breath or cough
  • Headache that is severe or associated with dizziness, weakness, or numbness
  • Eye problems, like sudden vision loss or blurry vision
  • Severe leg pain in the calf or thigh

We’re not trying to scare you away from birth control pills – like we said; millions of women use them and do just fine.  But now that you’re moving out into the world on your own, it’s important for you to be proactive and take charge of your health. Know your own medical history.  Know your family’s medical history.  And don’t be afraid to ask questions of your health care providers. 

If you have any questions about birth control options, the clinicians in our Women’s Services department are happy to help you figure out which options is right for you.

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

John A. Vaughn, MD
Student Health Services
The Ohio State University

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