Women
Birth Control
This question not only applies to pills but also birth control patches and vaginal rings, since they all are based on the same hormonal treatment approach: they all raise estrogen and progestin levels in a woman’s body. They only differ in how they deliver the hormones, i.e., orally, through the skin or through the vagina.
It is important to remember that birth control isn’t just taken to prevent pregnancies, even though that’s the main application. Birth control meds can help women manage menstruation irregularities and treat polycystic ovarian syndrome. Therefore, it’s not uncommon for women take birth control medications until they reach menopause.
Birth control pills on their own don’t pose a direct threat to “older” women, but they can augment the risk of medical conditions that occur with increasing age. The biggest concern may be an increased risk of forming blood clots (thrombosis). The risk of thrombosis increases with age, markedly so after 45. Using birth control pills further increases the risk.
Birth control won’t significantly raise the risk of thrombosis for girls and younger women, who don’t have a high risk to begin with. But it can make a difference for women aged 35 and older. If, in addition to being over 35 years old, a woman is a heavy smoker and/or overweight, the thrombosis risks are compounded further.
Therefore, if you are older than 35 and believe you have a reason to regularly take birth control pills, discuss with your doctor to fully understand the associated risks. You may want to consider taking progestin-only pills, as they have fewer side effects.
As you just read, with increasing age birth control pills may exacerbate the risk of blood clots. There’s also the risk that long-term pill use may raise your breast and cervical cancer risk. The scientific evidence for the latter is not entirely clear, but according to the American Cancer Society, it is likely. That said, these risks decrease again once a woman discontinues the pill.
On the upside, long-term pill use appears to reduce the risk of other cancers: a 2018 study of 100,000 women between 50 and 71 found that long-term birth control use lowered the risk of getting ovarian and endometrial cancer. This effect may be due to a reduction in ovulation when on birth control.
Practice Committee of the American Society for Reproductive Medicine. “Combined Hormonal Contraception and the Risk of Venous Thromboembolism: A Guideline.” Fertility and Sterility, vol. 107, no. 1, 1 Jan. 2017, pp. 43–51, www.ncbi.nlm.nih.gov/pubmed/27793376, 10.1016/j.fertnstert.2016.09.027. Accessed 15 Mar. 2020.
Girolami, A., et al. “Effect of Age on Oral Contraceptive-Induced Venous Thrombosis.” Clinical and Applied Thrombosis/Hemostasis, vol. 10, no. 3, July 2004, pp. 259–263, 10.1177/107602960401000308. Accessed 13 May 2019.
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