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.
Breast cancer: Increasing age and a strong family history are the most significant risk factors for the development of breast cancer. Other established risk factors include obesity, not having had children, and a late age at first full-term pregnancy. The identified groups of women that may be at increased risk of developing breast cancer before menopause are women who have used birth control pills for more than 8 years or who started using them at an early age. For a few women, the use of birth control pills may accelerate the growth of an existing but undiagnosed breast cancer.
If you are taking birth control pills, learn how to perform a breast self-examination. Notify your doctor any time you detect a lump. A yearly clinical breast examination is also recommended because, if breast cancer develops, medications that contain estrogen may cause it to grow quickly.
Depression: Hormones, such as estrogen, have been known to cause mood swings and symptoms of depression. If you have had clinical depression in the past, you may be more likely to experience it again while taking this medication. If you have depression or a history of depression, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking this medication contact your doctor as soon as possible.
Diabetes: Current low-dose birth control pills affect glucose control very little. If you have diabetes or a family history of diabetes, monitor your blood glucose closely to detect any worsening of blood sugar control after starting birth control pills.
Eyes: Women who are pregnant or who take birth control pills may experience fluid build-up in the cornea of the eye, which may cause visual disturbances and changes in tolerance to contact lenses, especially rigid contact lenses. Wearers of soft contact lenses usually do not experience difficulties. If you experience visual changes or alterations in tolerance to contact lenses, you may need to stop wearing the lenses temporarily or permanently.
Fibroids: If you have fibroids (leiomyomata), your doctor should closely monitor your condition. If sudden enlargement, pain, or tenderness occurs, contact your doctor to see if you need to stop taking the medication.
Headache: Birth control pills may cause the development or worsening of migraine symptoms. If you have a history of migraine headache, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Heart disease: Cigarette smoking increases the risk of serious heart disease and death. Taking birth control pills increases this risk, especially with increasing age. Studies show evidence that women who smoke and are over 35 years old should not use birth control pills.
Other women who have a high risk for heart disease include those with diabetes, high blood pressure, or abnormal cholesterol levels, or those with a family history of these conditions. Whether taking birth control pills increases this risk is unclear.
For low-risk, non-smoking women of any age, the benefits of birth control pill use outweigh the possible cardiovascular risks of low-dose pills.
Liver function: If you have reduced liver function or have had liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Regular check-ups: You should have a yearly physical examination and follow-up visit with your doctor.
Return to fertility: After stopping birth control therapy, you should delay pregnancy until at least one normal menstrual cycle has occurred in order to date the pregnancy. An alternative birth control method (e.g., condoms) 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: Birth control pills do not protect against sexually transmitted infections, including HIV/AIDS. For protection against these, use latex condoms.
Pregnancy: The hormones in birth control pills can affect the developing fetus if taken by a woman who is pregnant. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: The use of birth control pills while breast-feeding is not recommended. The hormonal components of the medication pass into breast milk and may reduce the quantity and quality of the breast milk. The long-term effects on the developing child are not known.