We’ve all heard about the Pill, the Patch and the Ring (and likely used one of them) and we’ve all seen the commercials telling us in pleasant voices about the possible risk of heart attack and stroke—though we probably never give those, or other side effects, a second thought. And why should we? The risk of heart attack is 0.06 per 100,000 non-smoking users, and there isn’t even significant risk for stroke. But while these combination forms of birth control (containing estrogen and progestin) are generally considered very safe, this doesn’t mean there aren’t a few things you haven’t heard about that could be good to know. Below, we’ve outlined a few of the lesser-known risks of combination forms of birth control, so you can be sure you’re being as safe and savvy as you thought you were! But before you get freaked out, keep in mind that these risks of birth control are very low. Risks on combination forms of birth control are higher than on progestin-only methods though, so be sure to find out which kind you’re on! Again, though these risks are small, we thought a smart HC girl like you deserved to be as informed as possible.
The Risk: Blood clots
The Info: Blood clots are semisolid masses of red and white blood cells stuck together, in short. If you have a blood clot, you might feel short of breath, have pain, swelling or redness in one leg and have leg cramps at night, have warm skin to the touch or have a bluish tint to your skin. If left untreated, blood clots will lead to hospitalization and could lead to death, says Carole Diamond, a Nurse Practitioner at the Colorado State University Health Network. But still, 30 to 50 percent of women with blood clots never have any symptoms, so make sure you’re making regular visits to your gynecologist if you’re on birth control. Even if you don’t have symptoms, a gyno would be able to detect a blood clot by using a D-dimer test, which would determine whether or not you need further evaluation.
What You Can Do: Don’t get too freaked out ladies! Diamond says she only sees a few women a year with blood clots, and Contraceptive Technology, a comprehensive guide to oral contraception, says the rate of blood clots in low-dose combination birth control users is 12 to 20 per 100,000. Also, make sure you tell your doctor if you have a family history of blood clots, because then she’ll know to be on the lookout for them. And if you start to notice any of above symptoms, go see your doc ASAP!
The Risk: Abnormal PAP Smears
The Info: PAP Smears were developed to test the cells in the vagina and an abnormal PAP Smear means abnormal cells are present. For a lot of women, abnormal PAP Smears might not show up until they’re older. They might have a positive test for cervical cancer and be wondering “What? I haven’t had sex in ten years!” But sometimes something like cervical cancer can manifest over time from an HPV virus contracted on a crazy night in college. Women who use hormonal forms of birth control—whether or not you want to hear it—are more susceptible to STD’s for a few reasons, Diamond says. If you’re using the Pill, the Patch, or the Ring, you probably feel like you’re having safer sex. Most women do. And in one way you are. But, since birth control users feel safer, they are less likely to use condoms. Not only does birth control act as a bit of a security blanket, but it also causes more delicate cells to be exposed, and these cells are more likely to pick up an STD, which would cause an abnormal PAP Smear. Since there are really no indications beforehand of an abnormal PAP Smear, aside from occasional genital warts, it can be tough to know what’s really going on down there.
What You Can Do: Although visiting your lady doctor might not be your favorite way to spend an afternoon, regular check-ups and PAP Smears are still important when you’re using hormonal birth control. The moral of the story: Unless you are positive your guy is STD-free, condoms are still a smart choice, even if you’re on birth control, and routine PAP Smears are a must.
The Risk: Higher chance of birth control side effects for smokers
The Info: Contraceptive Technology will tell you that if you smoke, you should stop or at least try to cut back because it is the single most important thing you can do for your health. For women over 35, smoking greatly increases the risks that come with being on birth control pills because it increases the risk of coronary heart disease. For young women with a low risk of heart problems, it is not a huge concern, but smoking is still not good for overall health (duh!).
What You Can Do: So, you might not have to worry about your nicotine fix interfering with your birth control now, but down the road it could become a serious problem. If you smoke, it’s extra important that you watch for the warning signals of the pill, which are:
- Abdominal Pain
- Chest Pain
- Headaches
- Eye Problems
- Severe Leg Pain
The Risk: Inconsistency, which leads to ineffectiveness
The Info: Let’s face it ladies. We’re all a little spacey sometimes! With school and friends and boyfriends (if we’re lucky) to worry about, we might not notice the time…or even what day of the week it is! But missing pills, and even taking them at different times from one day to the next, makes them less effective. And isn’t the point of taking them for them to be effective? That’s what we thought.
What You Can Do: Pills are supposed to be taken within two hours of the same time every day, Diamond says. So, set your phone alarm and keep your pills in your purse. It might interrupt a text every now and then, but you’ll be safer down the road.
The Risk: Interference with other meds
The Info: Some pills that women need to take for medical conditions can decrease the effectiveness of our birth control. If you take one of these meds, you might need to use a stronger pill or use a back-up method of birth control. Some of these meds include:
- Anticonvulsants (Tegretol, Trileptal, Dilantin, Mysoline, Topamax, Felbatol)
- Some over-the-counter meds (St. John’s Wort)
- Anti-tuberculosis (Rifampin, rifabutin)
- Antifungal
- Anti-HIV protease inhibitors
What You Can Do: Don’t keep secrets from your gyno! If you’re on any other medications, let your doc know, and if you start taking any new ones, give her a call so she can help you find the best birth control for your body! If you’re feeling uneasy about any of the risks we’ve mentioned, it’s always a good idea to pay your doc a visit. Meanwhile, remember that most doctors would assure you the benefits of birth control outweigh the risks as long as you’re not frequently missing pills or only taking them sporadically. And we don’t disagree. We just want to give you all the info you need so you can do what’s best for you and your body!
Sources: Carole Diamond, N.P. at Colorado State University Health Network www.webmd.com Hatcher R, Trussell J, Stewart F, Nelson A, Cates W, Guest F, Kowal D (2004). Contraceptive Technology. 425, 443 www.dictionary.com