Dear Alice,

I was wondering if there is a relationship between taking the pill and infertility. I have heard stories of women who have been on the pill for five or more years experiencing difficulty or no luck conceiving.

Some tell me that the birth control pill from several decades ago contained overly high dosages of hormones, and it were these high levels which led to infertility or conception problems. I was wondering if it is true that the older pills contained higher levels, and if so, what are the levels of the pills today? Also, what are the fertility risks associated with the pills available today?

—Cautious Kate

Dear Cautious Kate,

For a couple looking to become pregnant, it may seem as if all the stars must align first. On average, it takes couples eight months to become pregnant once they start trying. There are many reasons why women have difficulty conceiving — reasons that are unrelated to pill use. These include the age of partners, sperm count, frequency of intercourse, etc. Regardless of the birth control method being used, women (and men) may not encounter any underlying fertility problems until they stop using birth control and try to conceive.

First and foremost, many women take the pill to regulate their irregular menstrual cycles. Irregular periods are often due to hormonal imbalances. Presumably, this hormone imbalance will remain after a woman goes off the pill. This is because the cause of the imbalance has still not been addressed. An irregular menstrual cycle may translate to infrequent or irregular ovulation, making it more difficult for a woman to conceive. For tips on assessing ovulation time, you can check out Fertility awareness — natural birth control methods.

You are correct — today’s hormonal birth control pills have much lower doses of hormones than those prescribed decades ago. While equally effective, these lower-dose pills provide fewer side effects. The hormone levels in different types of birth control pills can range, as do the hormone combinations in each variety. A health care provider may be able to give you more specific information on different birth control pill prescriptions, as well as the possible side effects of each. S/he may be able to discuss contraceptive (and fertility) options.


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