While birth control pills are typically safe for most people to use long term, some evidence suggests they may increase your risk of blood clots and other side effects.
Hormonal birth control pills are one of the most popular birth control methods in the United States.
When you use them perfectly, contraceptive pills are very effective. So it’s common for people to take these pills long term — possibly for decades — without any problems.
But like all medications, you may experience some long-term side effects when taking these pills.
Knowing more about these possible side effects, ways to prevent them, and what alternatives are out there can help you choose a birth control method that’s right for you.
Weight gain
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Research suggests that fear of weight gain is a common reason for people to avoid contraceptive pills as a birth control method.
But a review from 2014 suggests that of 49 different studies on weight response to combination hormonal birth control, none show evidence that taking these medications causes weight gain. And a 2016 review on progestin-only pills had similar results.
If you think you are gaining weight while taking birth control pills, give it some time. Your body will be adjusting to new hormone levels, so some water retention may develop but will disappear with time.
If, even with an active lifestyle, you still notice weight gain, speak with a doctor about trying a different pill. You can choose from many different options, and they will help you find one better suited to your body.
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According to a review from 2023, over 40% of people taking systemic hormonal birth control (oral pills and implants) experience mood changes as a side effect of the medication.
Nearly half of people who stop taking the medication cite these mood changes for their decision.
The most common mood changes that people report from oral birth control are feelings of depression and low mood. You are more likely to experience mood changes as a result of oral birth control pills if you or a close family member have a previous history of depressive disorders or other mental health conditions.
Progestin-only birth control pills may carry an increased risk of causing mood changes than the combined pill.
If you have worries about experiencing mood changes with oral contraception, speak with a doctor. They may be able to advise on which type is best suited to your personal needs.
Cycle changes
Bleeding or spotting between periods is the most common side effect of birth control pills and is more likely with progestin-only medications. It is widespread and typically nothing to worry about.
This bleeding will go away within the first 3 months of taking these medications as your body adjusts to the new hormone levels. Make sure you take the pill at the same time every day. This will help minimize any irregular bleeding.
Blood clots
According to research from 2022, combined oral contraceptive pills containing estradiol — a synthetic version of estrogen — can increase your chance of developing thromboembolism, a type of blood clot. The progestin-only pills don’t have an association with this risk.
Blood clots can increase your likelihood of experiencing a stroke or heart attack. If you smoke, quitting can reduce your chance of developing blood clots while taking oral contraception.
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Certain long-term effects of oral birth control will continue as long as you take the medication, such as an increased risk of blood clots. But those that are responses to the changes in hormone levels may go away as your body adjusts to the medication.
For example, bleeding between periods should stop after a couple of months. If it doesn’t go away, speak with a doctor. Another type of birth control may suit you better.
The long-term risks of taking a contraceptive pill usually go away if you stop taking the medication — they shouldn’t continue.
Other options
If systemic hormonal birth control is not working for you, other options can help.
Intrauterine devices (IUD): These come as hormonal coils that release hormones locally inside your uterus (Mirena) or as nonhormonal copper coils (ParaGard).
Birth control patch: These are transdermal (through the skin) patches that release hormones, as long as you wear them according to the prescribed schedule. They are 93% effective and include the Xulane and Twirla patches.
Birth control shot:Depo-Provera is an injection that needs boosting every 3 months. This contains progestin, which prevents ovulation.
Vaginal ring: This is a small ring that goes inside your vagina and releases hormones to prevent ovulation. These include Nuvaring and Annovera.
All hormonal birth control methods can come with side effects. If you find that these side effects aren’t manageable, you can consider nonhormonal methods, including barrier methods such as condoms.
If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.
Summary
Hormonal birth control is safe to take for as long as you need it and as long as your doctor advises. But they carry a risk of side effects.
If you have a family history of depression or blood clotting, it is important to let your doctor know before they prescribe any birth control pills. This will help them give you the best type for your needs and prevent any long-term risks.
If oral contraception is not for you, you can try out other barrier methods, such as condoms.
