Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Blood clots: Blood clots are the most common serious side effects of birth control pills. Developing blood clots is especially high during the first year a woman ever uses a hormonal contraceptive. Clots can occur in many parts of the body (brain, eyes, heart, legs, or lungs). If you notice any of the following signs or symptoms that may suggest a potential clot, notify your doctor immediately.
- crushing chest pain or heaviness may indicate a possible heart attack
- pain or swelling in the calf may suggest a possible blood clot in the leg
- sharp pain in the chest, coughing blood, or sudden shortness of breath may indicate a possible blood clot in the lung
- sudden partial or complete loss of vision may indicate a blood clot in the eye
- sudden severe or worsening headache, vomiting, dizziness or fainting, disturbances of vision or speech, or weakness or numbness in an arm or leg may suggest a stroke
People with a blood clot or history of blood clot should not use this medication (See "Who should NOT take this medication?").
Blood pressure: People with high blood pressure should discuss with their doctor how this medication may affect their medical condition, and whether any special monitoring is needed. The use of this medication is not recommended in people with severe or uncontrolled high blood pressure.
Breast cancer: The chance of having breast cancer diagnosed may be slightly higher in women who use birth control pills, especially if you started using them at a younger age. You should have regular breast examinations by your doctor and examine your own breasts regularly. Women who currently have or have had breast cancer should not use birth control pills because the hormones in the pills may stimulate the cancer to grow. People who have or have had breast cancer should not use this medication (See "Who should NOT take this medication?").
Cervical cancer: Some studies have found an increase of cancer of the cervix in women who use birth control pills. This finding may be related to other factors other than the use of birth control pills. However, there is insufficient evidence to rule out the possibility that birth control pills may cause such cancers.
Cholesterol: Blood cholesterol or triglyceride levels may increase while taking this medication. People with cholesterol problems should discuss with their doctor how this medication may affect their medical condition, and whether any special monitoring is needed.
Cigarette smoking: Cigarette smoking increases the risk of serious heart disease and death. Birth control pills increase this risk, especially with increasing age (over 35 years of age). All women are urged not to smoke while taking this medication.
Diabetes: Birth control pills can affect blood sugar. People with diabetes or those with a family history of diabetes should discuss with their doctor how this medication may affect their medical condition, and whether any special monitoring is needed.
Emotional problems: Women with a history of emotional problems, especially depression, may be more likely to have a recurrence of their condition while taking birth control pills. If you notice your condition worsen while on this medication, consult your doctor.
Eye problems: Women who are taking birth control pills may experience fluid buildup in the cornea of the eye, which can lead to visual disturbances and changes in tolerance to contact lenses, especially the rigid type. Disturbances usually do not occur with soft contact lenses. If you experience visual changes or difficulty wearing your contact lenses, consult your doctor.
Fibroids: This medication may worsen fibroids, causing sudden enlargement, pain, or tenderness. If you notice these effects, contact your doctor.
Gallbladder disease: Women who use birth control pills have a greater risk of developing gallbladder disease. If you notice severe pain in the abdomen (stomach area), fever, or yellowing of skin or eyes (jaundice), contact your doctor immediately.
Heart diseases: Women at high risk for heart disease such as those with diabetes, high blood pressure, abnormal cholesterol levels, or a family history of these conditions should discuss with their doctor how this medication may affect their medical condition, and whether any special monitoring is needed.
Liver disease: Though rare, birth control pills can cause liver problems. If you develop yellowing of the eyes or skin, fever, fatigue, loss of appetite, dark urine, or light-coloured stools, stop taking the medication and contact your doctor.
Liver tumours: The short- and long-term use of birth control pills has been linked to the growth of liver tumours. Contact your doctor immediately if you notice yellowing of your skin or whites of your eyes, fever, fatigue, loss of appetite, dark urine, or pale stools. Stop taking the medication and talk to your doctor. People who have or have had liver tumours should not use birth control pills (See "Who should NOT take this medication?").
Migraine and headaches: The onset or worsening of a migraine or the development of new types of recurrent, persistent, or severe headaches should be reported to your doctor.
Regular checkups: Physical examinations and follow-up visits with your doctor should be done 3 months after starting this medication and then yearly thereafter.
Return to fertility: After stopping birth control therapy, you should delay getting pregnant until at least one normal spontaneous menstrual cycle has occurred in order to date the pregnancy. An alternative birth control method should be used during this time. If you do not menstruate for 6 months or more after stopping birth control pills, notify your doctor.
Sexually transmitted infections (STIs): Birth control pills do not protect against STIs, including HIV/AIDS. For protection against these diseases, use latex condoms in combination with birth control pills.
Pregnancy: Do not take birth control pills if you are pregnant. If you become pregnant while taking birth control pills, contact your doctor immediately.
Breast-feeding: The hormonal components of this medication passes into breast milk and may reduce the quantity and quality of breast milk. The use of this medication is not recommended for breast-feeding women.
Children and adolescents: The safety and effectiveness of using this medication have not been established for children and adolescents under 18 years of age. The use of this medication is not recommended before menarche (first menstrual period).
Seniors: The use of birth control pills is not recommended for postmenopausal women.