What are the risks of combination birth control pills?

Anthony L. Komaroff, MD
Internal Medicine
A combination birth control pill contains two hormones, an estrogen and a progestin. The hormones in the pill prevent pregnancy by keeping your ovaries from releasing eggs. Pregnancy can't happen if there is no egg to meet the sperm. The pill also thins the lining of the uterus and thickens the cervical secretions. Both of these actions also interfere with the fertilization process.

No method of contraception is perfect and the pill also has some disadvantages. Some women find taking the pill every day inconvenient or they have trouble remembering to take it. Some women have side effects such as nausea, headache, and break through bleeding (this is vaginal bleeding or spotting that takes place in between menstrual periods. This often happens while the body adjusts to the pill).

Serious complications are rare but can occur. Taking even a small risk may be unacceptable to some women. The serious complications associated with the use of the pill include heart disease, stroke, and blood clots. Complications occur most often in women with risk factors, such as smoking. Your doctor can let you know if the pill is safe for you based on your medical history.
Shelley C. Giebel, MD
OBGYN (Obstetrics & Gynecology)
Combination birth control pills contain estrogen and progesterone. Sometimes we need to limit the amount of estrogen due to risks of taking estrogen. Increased risks of blood clots are usually related to the estrogen in the pill. If someone has a history of blood clots, it would be best to use a progesterone only birth control method. Also, someone who has hypertension while on the birth control pills may benefit from progesterone only contraceptive methods. Patients that have a history of endometriosis would benefit from lower a estrogen level or progesterone only birth control methods.

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