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Specific Safety Concerns With Oral Contraceptives

Specific Precautions and Warnings With Oral Contraceptives

Warnings and precautions to be aware of prior to using oral contraceptives include the following:
 
  • Combined oral contraceptives (most of the pills currently available) increase the risk of blood clots, strokes, and heart attacks. These risks are quite small for healthy, young nonsmokers. However, tell your healthcare provider if you have ever had a blood clot, stroke, heart attack, or chest pain. Smoking cigarettes greatly increases the risk of serious oral contraceptive side effects, such as heart attack, stroke, and blood clots. This risk is particularly high for smokers over the age of 35.
     
  • Hormonal contraceptives, including oral contraceptives, can increase your blood pressure. This can be a problem if you already have high blood pressure.
     
  • Oral contraceptives do not protect against HIV, AIDS, or other sexually transmitted diseases (STDs). In many cases, women are advised to use condoms in addition to oral contraceptives.
     
  • Oral contraceptives can interact with a number of different medications (see Oral Contraceptive Drug Interactions).
     
  • Combined oral contraceptives (including most of the pills currently available) may slightly increase the risk of breast cancer or cervical cancer, although this is an unresolved and controversial issue. However, combined oral contraceptives seem to help protect women against ovarian and uterine cancer.
     
  • Oral contraceptives increase the risk of benign (noncancerous) liver tumors. In rare cases, these tumors can rupture and cause serious problems.
     
  • Hormonal contraceptives may make gallbladder disease worse. Therefore, if you have had a problem with your gallbladder, oral contraceptives may not be the best contraceptive method for you.
     
  • Oral contraceptives may increase blood sugar, particularly in women with diabetes. Your healthcare provider may need to monitor you more closely in this case. Let your healthcare provider know if you have any sudden vision changes, as this may be a sign of a blood clot in the eyes (a possible side effect of oral contraceptives and other hormonal contraceptives).
     
  • Oral contraceptives can change your menstrual bleeding patterns. Some women have breakthrough bleeding (bleeding between periods), while others may not have a period at all. It is normal to have shorter and lighter periods while using oral contraceptives. However, if you notice any unusual changes in your bleeding patterns, let your healthcare provider know. If you miss a period, you should make sure you are not pregnant.
     
  • Oral contraceptives can affect your cholesterol. Your healthcare provider may need to check your cholesterol levels after you start oral contraceptives, especially if you already have high cholesterol.
     
  • Sometimes, hormonal contraceptives may make depression worse. Let your healthcare provider know if you develop new or worsening depression symptoms while taking an oral contraceptive.
     
  • Occasionally, oral contraceptives can cause eye changes that make it more difficult to wear contact lenses.
     
  • Oral contraceptives are considered pregnancy Category X medications. This means that they should not be used during pregnancy (see Birth Control Pills and Pregnancy).
     
  • Contraceptive hormones, such as the ones in oral contraceptives, pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking an oral contraceptive (see Birth Control Pills and Breastfeeding).
     
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Oral Contraceptives Information

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