Birth Control Pills, Birth Control Transdermal Patch, Birth Control Vaginal Ring
Before you start taking or using any of the above methods, be sure you understand both the benefits and the possible problems of using combined hormonal contraceptives (CHCs). This page also lists the danger signs you should watch for. If you have any questions as you read, we will be happy to talk about them with you. Contact Women's Health Services at 212-443-1166.
You will get written information explaining the use, effectiveness, and medically recognized benefits and risks of the available birth control methods and devices and you will also get the FDA-approved information provided by the manufacturer. You should read these and ask questions about anything you do not understand.
CHCs contain the hormones estrogen and progesterone, similar to hormones produced by a woman's body. They primarily work to prevent pregnancy by keeping eggs from being released by the ovaries. You should not take or use them if you have reason to think you might be pregnant. For every 100 women who use CHCs, fewer than 5 will get pregnant the first year.
In addition to its value as a method of birth control, most women will have the following benefits from using CHCs:
- predictable, regular menstrual cycles
- decreased menstrual cramps and blood loss
- less iron deficiency anemia
- some protection from non-cancerous breast tumors and ovarian cysts
- less acne
- some protection from ovarian and uterine lining cancer
- decreased risk of infection of the pelvis (PID)
- fewer ectopic pregnancies
There may be less protection from pregnancy when CHCs are taken/used with certain drugs, especially those used to control seizures. You should talk to your clinician about what to do if you take any other medicine with the CHCs. If you see a health care provider for any reason, you should tell them you are taking CHCs.
CHC users have a slightly greater chance than non-users of developing certain serious problems that may cause death in rare cases, including:
- blood clots in the legs that can travel to the lungs
- stroke
- heart attack
- liver tumor
The chances of developing serious health problems increase with age over 35 years old and when certain other health risk factors are present, such as:
- smoking more than 15 cigarettes a day
- high blood pressure
- high levels of blood cholesterol or fat
- diabetes
You should not use CHCs if you have had, now have, or develop in the future:
- blood clots in the veins or arteries
- serious liver disease
- a heart attack or certain types of stroke
- cancer of the breast, uterus, or liver
- severe migraines
You may need special tests if you have certain medical conditions that could get worse while using CHCs. The risk to life and health is greater from pregnancy than from CHC use. Only for women age 35 or older who smoke more than 15 cigarettes per day or who have certain other medical conditions do CHCs carry a higher risk than pregnancy.
Minor reactions to CHCs may include:
- nausea, vomiting
- breast tenderness
- weight gain or loss
- spotting between periods
- skin irritation (with the Patch)
- vaginal irritation/discharge (with the Ring)
Watch for the following CHC danger signals and report any to a clinician immediately:
- sharp or crushing chest pain or coughing blood
- shortness of breath
- unusual swelling or pain in the legs or arms
- sudden severe headaches
- eye problems such as blurred or double vision or loss of vision
- severe pain in the stomach or abdomen
- yellowing of the skin or eyes
- severe depression
- unusually heavy bleeding from the vagina
- new lump in your breast
- no period after having a period every month
Using CHCs does not protect against sexually transmitted infections and a bad infection could cause sterility. If you or your partner have other sexual partners, you also should use latex condoms to prevent infections, even though you are using CHCs. Regular physical examinations for routine health care and for screening for sexually transmitted infections and for cancer are strongly recommended.