Hormonal Contraceptive Side Effects

A woman tends to choose birth control based on what she considers to be the most convenient and effective method for her. However, it’s important to weigh carefully the risks and side effects of hormonal contraceptives.


How Do Contraceptives Work?

Contraceptives are methods of preventing or ending pregnancy, also referred to as “birth control,” and work in three ways:

  1. Prevent Fertilization.
    Fertilization is the union of a man’s sperm and woman’s egg. Some contraceptives create a physical barrier to block sperm from reaching an egg. Male and female condoms and the diaphragm are examples.

  2. Make the Uterus Hostile to Implantation.*
    Contraceptives can attempt to prevent a baby from implanting in the mother’s uterus after fertilization by creating a hostile environment. Intra-uterine Devices (IUDs) and chemical methods are in this category.

  3. Alter Body Chemistry.*
    Typically referred to as “hormonal” contraceptives, synthetic steroids like the pill, depo, norplant, patch, IUD’s, mimic hormones to prevent pregnancy by changing a woman’s body chemistry, which has three impacts:
    •    Prevent ovulation, the release of the egg each menstrual cycle.
    •    Produce less and thicker mucus in the cervix so that sperm cannot easily enter the uterus.
    •    Thin the lining of the uterus, making it more difficult for a fertilized egg to implant.

Chemical contraceptives include the oral birth control pill, Depo-Provera injection, patch, implant, and the IUD. Chemical methods provide no protection against STDs and can actually increase your risk of getting an STD by making your reproductive tract more vulnerable to infection. [See Birth Control and STDs]

*Note: Methods in categories 2 and 3 can be ‘abortifacient,’ meaning that they end the life of a developing fetus.


The Pill, Depo-Provera Shot, Norplant, and Patch

  • Listed by the World Health Organization as a Class 1 carcinogen for increased risk of breast and liver cancers1
  • Multiplies risk of heart attack by up to 2.3 and risk of stroke by up to 2.22
  • Makes a woman’s reproductive tract more susceptible to infection, increasing her risk of contracting an STD by 30%.3
  • Increases risk of glioma, a rare brain cancer, by 50% with short-term use. Five years of birth control pill use doubles a woman’s risk.4
  • For nearsighted women, six months of using the pill has been shown to increase nearsightedness 2 or 3 times.5
  • Associated with decreased bone mineral density, weight gain and increased risk of breast cancer6
  • Multiplies risk of stroke by 3.27

 

More on Intrauterine Devices*

An IUD is a device placed in the uterus as a method of birth control.  These devices prevent pregnancy by interfering with sperm movement, egg fertilization, and possibly prevent implantation.

There are two types:

Copper IUD - brand name is Paragard and it is a small plastic t-shaped device wrapped in copper wire and is non-hormonal.  Side effects include a higher incidence of pelvic inflammatory disease, uterus perforation, and expulsion.  In some cases, surgical removal may be necessary. Although uncommon, pregnancy while using PARAGARD can be life threatening and may result in loss of pregnancy or fertility. 1

Hormonal IUD - brand name Mirena; the hormones are embedded in the plastic that are slowly released. Side effects include:  increased chance of tubal pregnancy, the possibility of embedment, which requires surgery to remove, and possible cysts on the ovaries. 2


*Note: This method can be ‘abortifacient,’ meaning that they end the life of a developing fetus.
*Note:  With “typical” use, 6% of women using Depo or The Pill will become pregnant in the first year.  If you find yourself in this position you have options.  Please know that we are here to help.  Give us a call or come in to our clinic and we can help you confirm pregnancy and see which option is right for you.
 

1.    Rosenberg MJ, Davidson AJ, Chen JH, Judson FN, Douglas JM (1992). Barrier contraceptives and sexually transmitted diseases in women: a comparison of female-dependent methods and condoms. Am J Public Health. 82(5):669-74.  
2.    Lidegaard Ø, Løkkegaard E, Jensen A, Skovlund CH, Keiding N (2012). “Thrombotic stroke and myocardial infarction with hormonal contraception.” N Engl J Med, 366(24): 2257-66.  
3.    Andersen L, Friis S, Hallas J, Ravn P, Kristensen BW, Gaist D (2014). Hormonal contraceptive use and risk of glioma among younger women a nationwide case-control study. Br J Clin Pharmacol. DOI: 10.1111/bcp.12535 [ePub ahead of print].  
4.    International Agency for Research on Cancer (1999). Hormonal Contraception and Post-Menopausal Hormonal Therapy. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, 72: 288-94.  
5.    American Society of Health System Pharmacists (2010). AHFS Drug Information 2010: Bethesda, MD, p. 3112.
6.    Bigrigg A, Evans M, Gbolade B, Newton J, Pollard L, Szarewski A, Thomas C, Walling M (2000). Depo Provera. Position paper on clinical use, effectiveness and side effects. Br J Fam Plann, 26(1):52-3.
7.     Lidegaard Ø, Løkkegaard E, Jensen A, Skovlund CH, Keiding N (2012). “Thrombotic stroke and myocardial infarction with hormonal contraception.” N Engl J Med, 366(24): 2257-66.

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