6 things you probably didn’t know about the birth control pill

1. The Pill can lower your sex drive

The Pill might make you feel more protected and at ease during sex, but it can also dampen your libido. “Most of the pills available in Canada contain estrogen and a synthetic progestin. It’s the same estrogen (17 beta ethinyl estradiol) in every pill, but the progestin changes pill to pill,” says Dr. Melissa Mirosh, Assistant Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of Saskatchewan. When women on the Pill complain of a lagging sex drive, the progestin is likely to blame. “We’ll switch pills to find one that doesn’t lower sex drive, or flip to another contraceptive method (non- or low hormonal IUDs) if the libido issue is big.”

2. Pill’s containing drospirenone (DRSP) are safe to use

In early 2013, the media reported that Yaz and Yasmin – birth control pills containing the synthetic progestin drospirenone (DRSP) – were associated with a higher risk of blood clots (Venous Thromboembolism, or VTE) when compared to other oral contraceptives currently on the market. According to the Society of Obstetricians and Gynecologists of Canada (SOGC) and several ongoing studies in Europe and North America, pills containing drospirenone actually have the same VTE risks as other formulations of the Pill.

On its website, SOGC says “that the risk of VTE in COC (combined oral contraceptives) users is very low and for most women, the benefits of this effective form of contraception will outweigh the risks. To maintain perspective, the risk of VTE in pregnancy and the postpartum period is much higher than with COC use.”

A woman on the Pill will increase her VTE risk further if she smokes, or is obese. Polycystic ovarian syndrome (PCOS) or a family history of clots will also contribute to a higher risk of VTE for women both on and off the Pill. It’s important to speak with your doctor about any risk factors you may have.

3. Your 40s might be the best time to take it

Women experiencing perimenopausal symptoms such as irregular bleeding, and hot flashes might find some relief taking the Pill. “If you’re a non-smoker, and aren’t dealing with high blood pressure or badly controlled diabetes, the Pill can be taken right up to menopause,” says Mirosh. “It’s often helpful for irregular bleeding in your 40s, as well as some hot flashes.”

Before your doctor will prescribe the Pill for irregular or excessive uterine bleeding, she’ll want to rule out more serious causes such as fibroids, polyps, and hypothyroidism – conditions that the Pill cannot fix.

4. Uncomfortable symptoms can appear years after you start the Pill

It’s a myth that bleeding control problems only occur when you begin the Pill. In reality, this issue can crop up years into your oral contraceptive routine because your body’s hormones change as you age. It’s not uncommon for a woman who has experienced no issues related to the Pill in her 20s, developing difficulties in her 30s or 40s. “Your Pill doesn’t change, but your body does,” says Mirosh. “Your body isn’t the same at 25, 35, or 45 years of age, and its reaction to the Pill might change as time goes by.” If you find that the Pill that you’ve been taking since your 20s is no longer reducing your bleeding each month, speak to your physician about switching to a different pill.

5. The WHO lists birth control pills as carcinogenic to humans

Lead, asbestos and tobacco are universally known as cancer-causing agents, but did you know that the World Health Organization (WHO) also lists birth control pills as carcinogenic? Studies have found that the Pill is associated with an increased risk of breast, cervical and liver cancer. “There’s an association with long term use of the Pill and breast cancer, but the rate is small and it hasn’t been confirmed that the Pill definitely causes cancer,” says Mirosh. “If you take the Pill for 3 years or less, there’s no elevated risk. Once you stop taking the Pill for 10 years your risk returns back to that of the general population.” While the Pill has been linked to an increased risk of certain cancers, it has also been associated with reduced risks of ovarian and endometrial cancers.

6. An unexpected – short term – use of the vagina

Worried that vomiting from food poisoning or the flu has left your Pill’s protection compromised? Your vagina can help. “If you can’t keep anything down, two pills inserted each day into the vagina works,” says Mirosh. The Pills will dissolve inside the vagina, and be absorbed into your bloodstream, but the key is to use two Pills instead of one because the vagina’s absorption isn’t as good as that of the digestive tract. “It seems to work quite well and the studies found that there wasn’t an elevated rate of pregnancy,” says Mirosh. To maintain contraceptive protection, follow your regular schedule. If you normally swallow your Pill at night, insert two Pills vaginally at night, placing them a finger length upwards inside your vagina. 

But this method is for short-term use only. Once you’re stomach has settled, taking the Pill orally – as it was intended – is still the best option. In the long run if you have trouble swallowing pills, Mirosh recommends discussing non-oral birth control options such as an IUD, patch, or vaginal ring with your physician.

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