Birth Control Pills - Are they really all that benign?

[astro]

In reading this it seems that birth control pills basically operate by manipulating the levels of powerful hormones. Obviously the risk benefit is positive for the BC pill users in that having an unwanted child is a more dire immediate circumstance than most other alternatives.

Long term however, if a woman takes BC pills for say 20 or 30 years, does long term use of birth control pills have any subtle permanent effects on a woman’s physiology (other than keeping her non-pregnant)?

[MLS]

IANAD, but have been told that these days some doctors will not prescribe BC pills to women who smoke. There is apparently an added risk of, IIRC, heart disease or stroke. I don’t know the exact underlying mechanism that is related to that.

[Stainz]

It’s the estrogen that carries the most risks - strokes (especially in women who smoke and are over 35), higher blood pressure … there are others but I can’t remember right now.

It has benefits though too - reduced chance of ovarian cancer is one.

They have “mini-pills” that don’t have estrogen - just the progestin - and they have less risks.

[WhyNot]

There are a number of side effects and potential health risks associated with the use of hormonal contraceptives.

  Common Side Effects for Combination Contraceptives
      o Weight gain
      o Increase or decrease in acne
      o Nausea and vomiting (particularly for the first few cycles)
      o Dizziness
      o Headaches
      o Depression
      o Vaginal infections
      o High blood pressure
      o Loss of libido
  Less Common Serious Health Complications
      o Blood clots in legs, lungs, heart or brain
      o Stroke
      o Liver tumors (rare)
      o Heart attacks
      o Gallstones (rare)
      o Jaundice (rare)
      o Possibly cervical cancer
  Common Side Effects for Progestin Only Contraceptives
      o Spotting and irregular vaginal bleeding
      o Longer periods
      o Amenorrhea for extend periods
      o Headaches
      o Anxiety and nervousness
      o Pain in lower abdominals
      o Dizziness
      o Loss of libido
      o Depression
      o Increase or decrease in acne
      o Skin rash or darkened patches of skin
      o Appetite changes
      o Weight gain
      o Tender breasts
      o Increase or decrease in facial and body hair
      o Possibly hair loss
      o Vaginal discharge
      o Bone density loss
      o Enlarged ovarian follicles
      o Pain or itching (usually for a brief period of time)
      o Norplant users: infection at the site of implantation
  Less Common Serious Health Complications
      o Ectopic pregnancy
      o Certain cancers

From http://www.epigee.org/guide/medfaq.html

[Smeghead]

Blood clots are a risk. There’s a link between estrogen levels and the clotting system, for obvious reasons. Usually, though, doctors won’t worry about it unless there are other risk factors present, like smoking.