Side Effects of Birth Control Pills

Although Birth Control Pills are an Effective Means of Contraception, They have Their Own Inherent Risks

• The most commonly observed side effects with these pills are nausea, weight gain, tenderness in breasts, reduced flow during the periods, spotting in between the periods, vaginal infections, and mood swings.
• Certain fetal abnormalities have been reported in about seven per 10,000 cases of exposure to birth control pills during pregnancy. These abnormalities include malformation of vertebrae, anus, kidneys, trachea, esophagus and limbs.
• Increased incidence of jaundice has been noticed in newborns when the mother has taken oral contraceptives around the time of conception.
• There have been instances of masculinization of female infants in around 3 per 1,000 cases of exposure to birth control pills, especially those containing norethindrone and norethynodrel.
• Lactating mothers, who consume birth control pills containing estrogen, have reported diminished milk production, reduced weight gain by the infants, and a decrease in the protein content of the milk.
• Women with a history of diabetes, hypertension, heart disease or high cholesterol taking birth control pills have a high chance of suffering from stroke in case they are smokers.
• Sudden pain in abdomen, severe headache, chest constriction, difficulty in vision, severe headache, and swelling and pain in lower limbs are indicative of certain rare but serious side effects of pills which include blood clots, liver or heart disease and cancer of uterus or breast.
• Concurrent use of medicines like antibiotics or anti-seizure drugs along with birth control pills can lead to a decrease in the efficacy of the latter. When used along with carbamazepine, Phenobarbital, phenytoin, primidone, rifampicin, etc, birth control pills may to prevent pregnancy because of their increased rate of elimination. Hence, women taking these medicines should opt for some other means of contraception.
• Certain women may suffer from melasma while using birth control pills. It is a skin condition, where you tend to develop hyper pigmented patches on your body, especially on those parts which are exposed to sun.
• Birth control pills containing estrogen inhibit the metabolism of medicines like Cyclosporine. This increases the level of drug in the blood and may damage the liver and the kidneys.
• Estrogen increases the liver’s ability to produce clotting factors. Therefore, women who are taking medicines for blood thinning should change the dose of their medicine accordingly, in consultation with their physician.
• Patients on dantrolene have an increased chance of developing liver damage if they take birth control pills concurrently.
• Morning after pills are contraindicated in women with liver damage or those suffering from a condition called porphyria.
• Certain women taking birth control pills suffer from a reduced sex drive.

Thromboembolism is a Rare but Dangerous Side Effect of Birth Control Pills

Birth control pills though very effective in spacing out the pregnancies, have a rare but dangerous side effect of thromboembolism. The contraceptive pills increase the liver’s ability to produce clotting factors. The resultant blood clots may travel through the blood stream and obstruct the lumen of some other blood vessel. This process is called as thromboembolism. The clot may obstruct the coronary blood vessels supplying the heart or may block the supply to some part of the brain resulting in stroke. When a clot blocks an artery supplying the lungs, the patient may develop severe respiratory distress. So it is essential to be aware of this potentially dangerous side effect of birth control pills and be alert of the warning symptoms which precede these life threatening conditions.

Thromboembolism is more common with birth control pills containing estrogen. Women who are overweight, travel frequently in cramped situations, have a sedentary life style or are bedridden because of some leg injury, those who smoke or those who have a family history of blood clots are more prone to develop this condition. These women are said to have a hypercoagulable blood which clots easily.

Early signs of deep vein thrombosis (DVT) which may lead to thromboembolism include:

• Tenderness or swelling on either leg
• Undue redness on the leg
• Increased temperature of one leg because of the presence of a clot
• Tightness around the chest
• Difficulty in breathing

Before starting the contraceptive pills, you can assess your chances of developing this complication by analyzing the presence of any risk factor and discussing it with your physician.

Birth Control Pills can lead to Breast and Uterine Cancers

Birth control pills have also been associated with an increased risk of developing breast and uterine cancers.

The Collaborative Group on Hormonal Factors in Breast Cancer collected worldwide epidemiologic data in 1996 and analyzed it. It was found that the birth control pills increased the risk of developing breast cancer, especially in women who started using these pills as a teenager. However, the risk is negated once the pills are stopped.

Birth control pills are also believed to promote cervical intraepithelial neoplasia (CIN), a condition which may ultimately lead to uterine cancer. CIN is an abnormal mutation of the cells on the surface of the cervix. This side effect is more commonly seen with pills containing estrogen. It is frequently seen in daughters born to women who had taken Diethylstilbestrol (DES) for contraception. According to a study, DES daughters are 2 to 4 times more likely to develop CIN as compared to unexposed women. The risk of developing CIN due to pills is in addition to the other risk factors for CIN like multiple sexual partners and exposure to Human Papilloma Virus (HPV). According to a recently published study, the risk of cervical cancer is doubled in women taking birth control pills containing estrogen for more than five years.  

The importance of birth control pills as a contraceptive method cannot be negated. The sole purpose of highlighting the side effects caused by pills is to make the women aware of them. You can discuss the pros and cons of using a particular contraceptive pill with your doctor and then take an informed decision so that you can enjoy the benefits of birth control pills without suffering from any deleterious effects.