Since 1960, when the birth control pill first hit the consumer market, its users have enjoyed health benefits, battled side effects and deliberated over disadvantages. Like any other drug, the birth control pill has its pros and cons.

The pill is an oral contraceptive taken daily and comprised of man-made hormones. It prevents pregnancy by working with the body’s natural hormones to prevent ovulation. The pill is one of the most widely used contraceptive methods; it is thought that over seventy five percent of women use or have used the pill as a form of contraception.

Most birth control pill packets contain three weeks of active pills, and one week of inactive ones. Inactive pills are usually a different color from active ones, and contain no hormones. Their purpose is to help regulate the schedule of when users take their pills; the effectiveness in preventing pregnancy will not be decreased if they are not taken. Other types of birth control pills do not include inactive pills in the packet. These kinds of pills are taken for three weeks, then the packet is discarded and the user does not take any pills for one week. At the beginning of the following week, a new packet is started again.

One of the reasons that the birth control pill is so frequently used is that it is one of the most successful forms of birth control. It is said to be 98% effective when used correctly; it is found to be approximately 95% effective when realistic human error is taken into account. However, with perfect use, its success rate can go as high as 99%.

There are many factors that contribute to birth control pill effectiveness. The first and most obvious is the consistency with which users take their pills. The more regularly the pill is taken, the more effective it will be in preventing pregnancy. Body weight is being investigated as another. A recent study shows that women over one hundred and fifty five pounds are 60% more at risk for getting pregnant on the pill than those weighing less. Researchers hypothesize that because the rate of drug absorption increases with heavier body weight, the pill may be metabolized more rapidly in heavier women, causing the hormones to be less effective. Antibiotics are another factor in pill effectiveness. According to the Mayo Clinic, the antibiotic rifampin has been specifically shown to interfere with the birth control pill preventing ovulation. Other studies suggest that antibiotics such as amoxicillin, metronidazole, tetracycline, cephalexin, erythromycin, and isoniazid could also impede pill effectiveness, though such studies are ongoing. Barrier methods can be used as an effective form of backup protection for the pill when taking antibiotics.

The pill is one of the easiest forms of birth control to reverse. The majority of women begin to ovulate between four to six weeks after coming off the pill. Some women, particularly women who initially had irregular periods, report longer amounts of time before getting their period once they stop taking the pill.

Many advantages independent of birth control have been associated with the pill. Pelvic Inflammatory Disease (PID) is thought to occur less frequently in women on the pill than women who have never used it. PID is an infection that can cause infertility, but doctors maintain that birth control pills cut the risk of acquiring it by 50%.

Birth control pills also offer a decreased risk of ovarian cancer. Medical science has known for a long time that the pill offers some protection from ovarian cancer, but when the low-dosage (pills containing a lower dose of hormones) first came out, there was some doubt about whether it offered the same shield. According to Roberta Ness of the University of Pittsburgh and WebMD, women on the pill enjoy a decreased risk of ovarian cancer by a massive 40%. Ness maintains that women must be on the pill from between one to four years to gain some protection from ovarian cancer; her study suggests that it continues for up to thirty years after going off the pill. There are two hypotheses that could account for the reduced risk of ovarian cancer. Natural hormones, when raised high enough, are suggested to have the ability to trigger ovarian cancer. Taking the pill regulates and reduces the amount of natural hormones that are produced. The second factor is that the pill, in preventing the ovaries from producing an egg each month, eliminates inflammation, which is also linked to ovarian cancer.

The pill has additionally been found to provide some protection against endometrial (uterine) cancer. In women using combination oral contraceptives (COC’s), the risk of uterine cancer was found to be diminished by roughly 40%. Evidence indicates that the decreased risk continues for up to fifteen years. Additionally, 4 years of COC use was thought to produce a reduced risk of about 56%.

Birth control pills have been linked to the stabilization of chronic pelvic pain as well. Chronic pelvic pain is pain that has been present in the abdominal or pelvic area for six months or more. By preventing ovulation, and decreasing the amount of blood loss, the birth control pill lessens monthly cramps and discomfort. It also controls the levels of natural hormones the body normally produces, frequently a cause of pelvic pain.

Not only can birth control pills minimize pain with periods, but they can also be used to stave off menstruation entirely. Instead of beginning the fourth week of inactive pills, or not taking any pills at all for the fourth week, birth control users will simply begin a new packet at the end of three weeks, never stopping the active pills. While some women experience spotting, the majority of women find that this procedure efficiently bypasses their period completely. There is no current evidence suggesting that this practice is harmful. In fact, a new kind of pill called Seasonale, an ‘extended cycle pill,’ is being marketed to women who experience exceptionally painful cycles and would like to have fewer periods. This pill is taken for eighty four consecutive days, followed by a seven day interval of inactive pills.

Another potential advantage for being on the pill is an increase in bone density. According to WebMD, in an Australian based study, researchers found that women on the pill experienced a 3.3 % amplified bone density than women not on it. Additionally, women who were on the pill for over five years experienced an extra 0.2% increase in bone mass every year. Studies show that the birth control pill does fortify the human skeleton to some extent. The study done at the University of Melbourne in Australia did not separate the women according to type of birth control pill they were on, so there is no decisive indication about one pill’s effectiveness over another. More research is needed to determine how effective the birth control pill is at preventing bone loss as a whole.

Being on the birth control pill for five years or more may also increase fertility. While previous studies have traditionally warned consumers about the tribulations of trying to get pregnant after stopping a long term contraception method, new research done in England actually shows that long term use of the birth control pill may actually aid in conception. The study examined almost eighty five hundred couples planning pregnancies in the 1990’s, and found that the probability of pregnancy within six months to a year was actually higher in women who had taken the pill for over five years, than in women who had not taken it at all. 75.4% of women on the pill got pregnant within only six months, compared to 70.5% of women who had never been on the pill.

But with all its conveniences like skipping periods and eliminating cramps, or benefits such as reduced risk of cancer and osteoporosis, the pill also brings a whopping catalog of drawbacks with it.

Firstly, substantial evidence strongly suggests that there is a sound link between the birth control pill and breast cancer. Over one hundred thousand women participated in a lengthy study conducted by epidemiologists at the Institute of Community Medicine in Norway. After eight years from the beginning of the study had passed, over one thousand women had developed breast cancer. When compared with women who had never used the pill, the increase in breast cancer was by 26%. Women who were still using the pill faced an increase of 58%. Although the risk for women over the age of forty five is significantly higher, if recent studies are correct, breast cancer in all ages can be linked to the birth control pill by 15%. According to the American Cancer Association, the growth of breast tissue is determined by hormones, making hormone-containing drugs a potential threat; oral contraceptives in particular have been found to increase the risk of breast cancer.

Birth control pills have also been associated with a heightened risk of cervical cancer in women with Human Papilloma Virus (HPV). According to a compilation of twenty eight different studies, cervical cancer risk was doubled in women using birth control pills for over a decade from that of women who had never used them. The majority of doctors do not, however, recommend changing birth control methods due to these findings if women have regular screenings for cervical cancer and HPV. Risks for cervical cancer in women who have stopped taking the pill have not yet been determined.

Oral contraceptives have additionally been found to increase the risk of stroke. Estrogen, which one of the hormones in the birth control pill, has been known to promote blot clots. When blot clots happen in the brain, they cause a stroke. Women taking the pill are typically of child-bearing age, an age not normally common for experiencing a stroke. However, research shows that the risk of stroke for women on the pill is doubled compared to women not on the pill.

According to the Mayo Clinic, taking the pill for any extended amount of time may increase blood pressure. Women who already have high blood pressure should seek alternate forms of contraception. If blood pressure is raised by the birth control pill, usage of the pill should either be discontinued or blood pressure should be routinely and carefully monitored.

And the pill provides a higher risk of disease in general for smokers. Smoking is the first thing on the “don’t” list for women taking the pill. Studies have shown that light smokers are one fourth as likely to die from any cause if they are taking the pill, and heavy smokers are twice as likely. A higher risk of death from both heart disease and cervical cancer has been found in women smokers on the pill, than women nonsmokers on the pill and women smokers not on the pill.

Additionally, birth control pills have been connected with higher levels of a C- reactive protein, a protein associated with heart disease. Women who took birth control pills in a recent study were found to have twice the amount of C-reactive protein in their blood than women who did not take oral contraceptives. Birth control pills are potentially related to inflammation, which has been linked to heart disease. Detailed evidence of the increased risk of heart disease from taking the pill is currently inconclusive.

Oral contraceptives have less serious side effects as well; among them are nausea, mood swings, headaches, or weight gain. However, most weight gain is less than five pounds, and frequently drops off after a few months of using the pill. In rare cases, women will gain muscle due to the increase in testosterone that the pill might have on some women.

Ongoing research also suggests that taking birth control pills may decrease female sex drive. Researchers theorize that this could be related to the low presence of the male sex hormones (androgens) in many females taking the pill. Female sexual response is largely due to these hormones; therefore pills that have low levels of them can potentially decrease it.

When it comes to deciding on a contraception method, a lowered risk of ovarian cancer or a potential increase in bone density might be the determining factor for those who have a history of cancer or osteoporosis. However, women who smoke, carry a history of heart disease or breast cancer, may elect to bypass the pill as a pregnancy prevention option. See your doctor for more information about benefits, drawbacks, and side effects of oral contraceptives, and also to decide if they are right for you.