For many, hormonal contraception provides effective and convenient pregnancy prevention, and can also offer significant non-contraceptive benefits, such as treating endometriosis and heavy periods. When considering long-term use, like being on the pill for a decade, it's essential to weigh the potential risks and benefits based on your personal health profile. Medical professionals agree that for most healthy people, there is no set time limit for safe use, but ongoing evaluation is recommended.
Potential risks of long-term hormonal birth control
Cancer risks
Long-term hormonal birth control has been linked to a complex interplay of cancer risks. It's not a straightforward increase for all cancer types; some risks are elevated, while others are reduced.
- Breast Cancer: Some studies have found a slight increase in the risk of breast cancer among current and recent users of hormonal contraceptives. This risk, however, is considered modest, especially for younger women, and decreases over time after discontinuing use, returning to a baseline level approximately 10 years later.
- Cervical Cancer: Research indicates that using hormonal birth control for 5 or more years may increase the risk of cervical cancer, particularly in women with persistent HPV infections. Like breast cancer, this elevated risk diminishes after stopping the medication.
- Protective Effects: Importantly, hormonal birth control use can significantly reduce the risk of other cancers. Studies show a lower risk of ovarian, endometrial, and colorectal cancers, with the protective effects lasting for decades after cessation. For ovarian and endometrial cancers, this protection appears to increase with longer duration of use.
Cardiovascular risks
Certain hormonal methods, particularly combined pills containing estrogen, can increase the risk of blood clots, which can lead to serious events like heart attack and stroke. This risk is higher for women who are over 35 and smoke, have high blood pressure, or a history of cardiovascular disease. Progestin-only pills and hormonal IUDs generally have a lower cardiovascular risk profile.
Bone mineral density
Long-term use of the progestin-only birth control shot (Depo-Provera) has been associated with a temporary decrease in bone mineral density. However, this bone loss is generally reversible after stopping the injection, and it is not a documented risk for other hormonal methods like the pill or IUD.
Long-term fertility and hormonal birth control
One of the most persistent myths is that long-term use of hormonal birth control, including for 10 years or more, will negatively affect a person's future fertility. This is not supported by scientific evidence.
- No Impact on Fertility: Studies have repeatedly shown that prior use of birth control, even for many years, does not harm a person's ability to become pregnant later.
- Return to Fertility: After stopping hormonal birth control, it may take a few months for your regular menstrual cycle to return as your body's natural hormone production resumes. Most people will become pregnant within a year of stopping, similar to those who have not used hormonal contraception.
Risks and benefits: A comparative table
| Feature | Risks of Long-Term Hormonal Contraception | Benefits of Long-Term Hormonal Contraception |
|---|---|---|
| Cancer | Increased Risk: Breast and cervical cancers (temporary risk that declines after stopping). | Reduced Risk: Ovarian, endometrial, and colorectal cancers (protective effect lasts for years). |
| Cardiovascular | Increased Risk: Blood clots, heart attack, and stroke (especially for smokers over 35 or those with pre-existing conditions). | Potential Benefit: Can help manage conditions related to irregular cycles that impact heart health. |
| Fertility | Impact: None, prior use does not affect future fertility. | Benefit: Regulates menstrual cycles and can manage conditions like endometriosis, which could potentially impact fertility. |
| Menstrual Cycle | Symptom Management: May alleviate heavy bleeding, painful periods, and PMS symptoms. | Rebound Effect: Return of original menstrual symptoms after cessation. |
| Other Side Effects | Potential Side Effects: Mood changes, headaches, and breakthrough bleeding (often decreases over time). | Positive Side Effects: Can help with acne, lessen migraines, and offer relief from endometriosis pain. |
Making an informed decision for long-term use
Consult your healthcare provider
The most important step when considering long-term birth control is to have an open and honest conversation with your doctor. Your medical history, family history, and lifestyle factors are critical in determining the safest and most suitable method for you. A doctor can help you understand your individual risk factors and explore alternatives if necessary.
Re-evaluate periodically
Your health needs and life circumstances can change over time. What was the best choice for you a decade ago might not be today. Regular check-ups with your gynecologist provide an opportunity to reassess your contraceptive method, ensuring it still aligns with your health and family planning goals. Some changes, such as a shift in smoking habits or a diagnosis of a new medical condition, may require an adjustment to your birth control.
Consider alternative methods
While long-term use of hormonal birth control is often safe, it is not the only option. Long-acting reversible contraceptives (LARCs), such as hormonal or non-hormonal IUDs and the implant, offer highly effective, long-term options without the need for daily pills. Exploring these and other options can help you find a method that best fits your evolving health needs and lifestyle.
Conclusion
So, is it bad to be on hormonal birth control for 10 years? The consensus from the medical community is that for most healthy women, it is not bad and can be done safely with a doctor's supervision. Long-term use comes with a complex balance of risks and benefits, including a modest, temporary increase in the risk of some cancers and potential cardiovascular concerns, alongside a significant protective effect against other cancers and various non-contraceptive benefits. Importantly, long-term use does not impair future fertility. The best approach is to maintain regular communication with a healthcare provider to ensure your chosen method remains the safest and most effective option for you over time.
Long-term effects of birth control: Is it safe to use indefinitely?
