What are the long-term effects of birth control pills?

Originally Published: July 29, 2005 - Last Updated / Reviewed On: July 11, 2014
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Alice,

I have searched your archives but have not found an answer to my question, and I was wondering if maybe you could help me out. I was wondering about the effects of taking birth control pills for an extended period of time and how long one can safely take them. Any information/advice you could give me would be greatly appreciated.

-Looking for answers

Dear Looking for answers,

Thanks for doing a little digging around the archives! Weighing the benefits and risks of long-term medication like birth control pills may be a little confusing — there is certainly a lot of information out there. Luckily, current research provides a lot of comprehensive information about the many health benefits of oral contraceptives (OCs) and also dispels a lot of misconceptions about risks associated with long-term use.

Birth control pills are a safe long-term contraceptive method for non-smokers. For most healthy non-smokers, prolonged use of OCs doesn't appear to have adverse effects, and as a result, is an effective birth control method to use throughout reproductive years. The safe use of OCs depends upon careful evaluation and knowledge of patients’ health history by health care providers (so, it’s best to communicate regularly and honestly with your health care provider). Now, let’s move forward with a summary of the medical findings regarding long-term use of birth control pills. First, a little myth busting…

Myths debunked about long-term birth control pill use:

  • There is no medical indication for "taking a break" from OCs. While some medical providers previously recommended temporarily stopping birth control use, this is no longer advised. In fact, if stopping OCs puts someone at risk for pregnancy, it is not recommended.
  • Birth control pills have no adverse effect on future fertility, do not defer menopause, nor do they hasten menopause's onset. Many people ovulate within a couple of weeks of discontinuing OCs. Less than 3 percent of birth control pill users have a delay in the return to fertility. So people can expect to return to the menstrual pattern that existed prior to OC use. Also, OCs do not correct any underlying ovarian dysfunction.

Decreased and increased cancer risks with birth control pills:

  • Long-term use of birth control pills can reduce the risk of endometrial and ovarian cancer. In general, use of OCs reduces a person’s risk of developing both endometrial cancer and ovarian cancer. And protection against endometrial cancer only increases with prolonged use. This protective effect persists even after discontinuation of the pill.
  • Birth control use has minimal, if any, impact on risk of breast cancer. Research on the correlation of OC use and increased risk of breast cancer has found that while breast cancer risk may increase slightly during the first two years of use, this risk returns to pre-OC levels ten years after discontinuation. Current users of OCs may be slightly more likely to be diagnosed with breast cancer due to the likelihood of regular medical visits, including breast exams. Many experts have concluded that OCs have little or no effect on breast cancer risk.
  • Birth control users may have an increased risk of cervical cancer. Cervical cancer is commonly caused by the human papilloma virus (HPV). Long term use (five or more years) of OCs is associated with an increased risk of cervical cancer. However, it’s not clear whether OC use decreases the body’s ability to fight off HPV or if there’s another indirect reason for the higher risk.
  • Birth control users may have an increased risk of liver cancer. OC use has been linked to increased risk of benign liver tumors. Though some research indicates that more than five years of OC use may increase a person’s likelihood of developing malignant (potentially cancer causing) tumors on the liver, other studies have not found this association.

Reasons birth control pills may not be right for you:

  • use of tobacco products, especially for those over 35 years old
  • uncontrolled, high blood pressure
  • blood clotting disorders
  • obesity
  • prolonged bed rest or immobilization
  • vein problems
  • heart problems, including history of stroke or heart attack
  • elevated eye pressure
  • family history of glaucoma
  • diabetes
  • breast feeding
  • migraine headaches

Speaking with a health care provider will help you get answers to specific questions about birth control as it relates to your individual medical history. If you’re a Columbia student, you can make an appointment through Medical Services (Morningside) or the Student Health Service (CUMC). Also, check out the Go Ask Alice! Contraceptives archives or Planned Parenthood for additional information and research updates.

Lastly, keep in mind that birth control pills don’t protect against sexually transmitted infections (STIs). For information on ways to reduce STI transmission, feel free to read through the Go Ask Alice! Safer Sex archives.

Best of luck in your birth control decision-making!

Alice