The Effects of Long-Term Birth Control Use
There is a lot of information out there about hormonal birth control pills, and it can be scary reading about the negative side effects some women have experienced, both while using birth control and after going off of it. Every person is different, though, and someone else's experience with hormonal birth control pills isn't necessarily going to be what you will experience.
We talked to several medical professionals about what you need to know about birth control, so you can make the decision that's right for you in consultation with your doctor.
How long is too long to be on the birth control pill?
There is extensive debate about whether it's possible to be on birth control pills for too long, but our experts agree there doesn't seem to be a time limit.
"At this time, there is no official stance on how long one should be taking birth control," stated Betsy Greenleaf, D.O., FACOG. "The general consensus is as long as a person is healthy they can stay on birth control up until menopause."
Greenleaf said there seems to be a general belief that a woman's body "gets used to" a specific birth control, causing women to need to change it up, but that's not necessarily true.
'The general consensus is as long as a person is healthy they can stay on birth control up until menopause.'
"Getting used to birth control has less to do with the birth control brand itself than just normal changes in metabolism that occur," she explained. "It is fine for someone to be on the same birth control their whole life as long as they are not having side effects, such as breakthrough bleeding."
The risks and side effects associated with the pill don't accumulate over time and if you're otherwise healthy, these risks should be very minimal.
Effects of long-term birth control use
Many of the risks associated with the pill can be reduced by maintaining a healthy lifestyle.
For example, Greenleaf explained that smoking isn't advised while on birth control because this places the patient at much higher risk for blood clots, heart attack and stroke—especially if the patient is over 35.
"What it comes down to is the synthetic hormones used in birth control can be inflammatory," she said. "If you are already leading a poor lifestyle, such as smoking, drinking alcohol (which increases estrogen levels), eating inflammatory foods, like processed foods and sugars, and not exercising, the risks of the inflammation caused by birth control will magnify."
Leading a healthy lifestyle with a well-balanced diet is also important because studies show birth control can cause long-term nutritional deficiencies. "Birth control can cause deficiencies in folic acid, vitamins B2, B6, B12, vitamin C and E, and the minerals magnesium, selenium and zinc," Greenleaf noted.
These nutritional deficiencies can exacerbate pre-existing issues, such as hair loss, decreased immunity and decreased healing, explained Greenleaf. Such deficiencies can also create complications in pregnancy once a woman stops birth control.
It's important to note not all side effects of birth control are negative. Greenleaf listed a few positives of long-term birth control use:
- Decreased risk of ovarian and uterine cancer
- Less cramping and bleeding
- Decreased risk of pregnancy
- Emotional and sexual freedom
- Decreased acne
- Decreased ovarian cysts
- Decreased pelvic pain
- Decreased side effects of endometriosis and fibroids caused by polycystic ovarian syndrome (PCOS)
- Ability to time menses around life events
"Anyone with medical conditions, such as seizure disorders, heart disease, obesity and metabolic syndrome should check with their doctors about the usage of hormonal contraceptives," advised Greenleaf.
Sophia Yen, M.D., MPH, cofounder and CEO of Pandia Health, added it's not always about how long someone is on birth control, but what the birth control contains.
"If you have certain medical conditions, you should not be on estrogen-containing birth control pills," Yen said. "Some examples of these conditions include personal history or blood clot[s] in your head, chest, leg or lungs, liver cancer, high blood pressure and more."
Going on and off birth control
The reasons to go on birth control are unique to the individual. Some go on it to balance hormones, help clear acne, regulate periods, decrease period pain—or of course—to prevent pregnancy. The choice to go off birth control is also a personal one, and there are things to keep in mind if you do.
The birth control pill is simply telling your hormonal axis what to do when, so it's the driver for your cycle, explained Andi Schmerin, PA-C.
"Because you are typically taking small amounts of estrogen and progesterone over time, your body will not produce the same levels to account for what you are taking," Schmerin said. "Once you stop taking it, your body will get a signal to start producing them again."
The choice to go off birth control is also a personal one, and there are things to keep in mind if you do.
Side effects can vary significantly when going off the pill. Whatever symptoms you may have experienced prior to going on the pill may come back, Schmerin warned. Depending on your age, you should expect a normal cycle after three months. If, after this time, your cycle has not regulated, you should talk with your healthcare professional.
It's always best to seek medical advice from your OB-GYN if you are trying to get pregnant, but especially if you'll be going off a birth control pill designed to treat other conditions or pain.
Schmerin said it's important to talk to your doctor if you're experiencing extreme mood fluctuations, pain or discomfort with your cycle, or skin changes. She also noted that weight gain is not a side effect of stopping the pill.
"Officially, there are no problems coming on and off birth control, but I would advise against it," Greenleaf added. "Hormonal fluctuations can have effects on mood and general health. The body naturally wants to be in balance and when you come on and off this could be perceived as a stressor to the body, thus affecting other hormone balances, such as cortisol and the immune system."
