The Good, the Bad and the Ugly Sides of the Pill

Arguments for and against the safety of oral contraceptive pills are as old as the pill itself. What cannot be argued with is the fact that it is the most effective reversible method of keeping you from getting pregnant. So does the pill deserve the status of possibly the most popular medication in history?

Most side effects of the pill are not dangerous to your health. The common ones include nausea, spotting and bleeding between periods, mood changes, light depression, weight gain, breast tenderness and difficulty wearing contact lenses due to eye dryness. These side effects, especially nausea, usually subside within the first 3 months of use.

The threat of blood clots, heart attack and stroke were a problem related to the original high estrogen levels present in the early pills. The low-dosage pills have since been tested and cleared of suspicion. Unless the women are smokers, in which case they are recommended to quite either smoking or the pill after age 35, healthy women do not have any greater risk of these diseases if they are on the pill, compared to women their ages who are not pill users.

The relationship between cancer and the pill is continuously being studied. Much research has looked into the possible link between the pill and breast cancer, because estrogen may be dangerous for certain women, such as those with particular conditions or family histories. Some studies found that the pill was responsible for some cases of breast cancer, but most of the studies done could not find any such link.

With cervical cancer there is another debate. There seem to be more cases of cancer among women who have been on the pill, but we know that women on the pill are generally more sexually active than women not on the pill. This means that pill users are might be more likely to get cervical cancer due to their behaviour and not due to the pill itself. Nevertheless, this possibility needs to be understood fully and that demands more research.

Other forms of cancer that have been mentioned in regard to the pill are cancer of the ovaries and of the endometrium (the lining of the uterus). In these two cases research has found that the pill actually reduces the risk of cancer. So, as they say, choose your poison.

One of the problems rarely mentioned by health care professionals when providing the pill is that it adversely effects a woman’s libido: although having worry-free sex can add to your pleasure, the hormones in the pill actually leave women with a weaker sex drive. Some women turn to help to improve their sex drive and so it should be made clear that if this becomes more of a problem that the issue of not worry of conception, then another method of birth control needs to be sought.

Looking at the side effects, most experts agree that the advantages offered by the pill outweigh the risks. Remember that pregnancy, especially after multiple pregnancies, is itself a health risk for the mother. Women with heavy and irregular periods benefit from the pill lightening and regulating their periods, which often reduces anemia.

Pills can be used without the seven day break that brings on bleeding. This will allow a woman to have a cycle without her period at the end, and move directly onto the next cycle. On this principle, a new pill called Seasonale became available in 2003. This 12-week course of pills means that a woman will have only four periods a year. There is a lot of controversy about such an unnatural intervention, but the truth is that when a woman is on the pill, the periods she gets are not real signs of ovulation, because the pill stops her from ovulating. Instead it is a pseudo period, meant to fake a normal cycle, which the original inventors of the pill (who were all male) believed women needed in order to feel healthy.

What are the benefits of the Pill?

    • It is the most effective reversible (non-permanent) contraceptive method available (under 1% failure rate, means fewer than 1% of women using them properly over a year will become pregnant)
    • There is a wide range of pill choices, so some side effects could be eliminated by simply trying another version
    • It is suitable for use by a high proportion of women
    • It allows sex to be spontaneous
    • It provides some protection against some cancers
    • It helps with pain related to menstruation
    • It reduced the amount of bleeding, and sometimes the length
    • Use can be continued for many years without need for a break
    • It is extensively researched


What are the drawbacks of the Pill?

    • It does not protect against STIs (sexually transmitted infections)
    • It decreases the libido
    • It can have a lot of minor side effects such as headaches, nausea, skin problems, mood swings and weight gain
    • There could be serious side effects, although these are extremely rare
    • This method is relatively expensive, if not subsidized by your health care provider
    • It cannot be taken by women who are nursing during the first 6 weeks; while nursing special pills are required


Who should not be on the Pill?

    • Women who smoke heavily (more than 14 cigarettes a day) have an increased risk of heart attacks and stroke, especially after age 35. The risk increases with age.
    • Women who are obese
    • Women who have diabetes
    • Women with high blood pressure
    • Women with high cholesterol
    • Women with a history of blood clots
    • Women with a history of heart attack or stroke
    • Women with a history of liver disease
    • Women with a history of breast cancer or cancer of the sexual organs
    • Women with a family history of clotting disorders

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