What happens to the body when you take contraceptive pills every day?

The contraceptive pill, a widely used form of birth control, has become an integral part of many women’s daily routines. While its primary function is to prevent pregnancy, taking this hormone-based medication can trigger a series of complex changes within the body. 

From altering hormone levels to affecting various organ systems, the contraceptive pill’s impact extends far beyond its contraceptive effects. Dr Gaana Sreenivas, senior consultant obstetrician and gynaecologist at Bone and Birth Clinic, Bengaluru, tells indianexpress.com about the effects of consuming it every day. 

She says, “Contraceptive pills (often called ‘the pill’) are a widely used and effective form of birth control. Most birth control pills are classified as combined oral contraceptives (COCs), containing synthetic forms of oestrogen and progestin. These hormones orchestrate a symphony of changes to prevent pregnancy.”

These are:

Ovulation Suppression: The primary mechanism of action is the suppression of ovulation. Oestrogen and progestin inhibit the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. These hormones are crucial for the development and release of an egg from the ovaries. COCs consistently suppress ovulation in over 99% of cycles, according to research.

Thickened Cervical Mucus: Progestin alters the consistency of cervical mucus, making it thick and impenetrable to sperm. This creates a physical barrier that prevents sperm from reaching the egg.

Altered Uterine Lining: Progestin also thins the lining of the uterus (endometrium), making it less favourable for the implantation of a fertilised egg.

Short-term and long-term side effects of taking contraceptive pills daily

Contraceptive pills, like any medication, can have side effects when taken daily. The experience varies widely among individuals, and not everyone will experience all potential effects, shares Dr Sreenivas.

Short-Term Side Effects

Dr Sreenivas elaborates, “Common short-term side effects include nausea, breast tenderness, breakthrough bleeding, headaches, mood changes, and decreased libido. These typically subside within the first few months as the body adjusts to the hormones.”

Smoking significantly increases the risk of cardiovascular complications (Source: Freepik)

Long-Term Side Effects

Long-term use of COCs has been associated with a slightly increased risk of venous thromboembolism (VTE), a type of blood clot, says Dr Sreenivas. “A meta-analysis published in The BMJ medical journal found that the risk of VTE is approximately two to four times higher in COC users compared to non-users. However, this risk remains relatively low.”

However, there are some potential benefits as well. “The pill isn’t just about preventing pregnancy. It also offers numerous non-contraceptive benefits, including lighter and more regular periods, reduced menstrual cramps, and decreased risk of ovarian and endometrial cancers. A large prospective study published in The Lancet found that COC use was associated with a 50% reduction in the risk of ovarian cancer,” explains Dr Sreenivas. 

Specific health conditions or lifestyle factors that could make contraceptive pills less effective or unsafe

Smoking: Smoking significantly increases the risk of cardiovascular complications, particularly in women over 35 who use COCs. The World Health Organization recommends alternative forms of contraception for women who smoke.

Medical Conditions: Women with a history of VTE, high blood pressure, liver disease, or certain types of cancers should not use COCs.

Drug Interactions: Some medications, such as certain antibiotics and anti-seizure drugs, can interact with COCs and reduce their effectiveness.

Can taking contraceptive pills daily affect fertility?

Dr Sreenivas agrees that one common concern is whether taking the pill will affect future fertility. She says, “Rest assured, the pill does not typically have long-term effects on fertility when taken daily. Once you stop taking it, ovulation and menstruation usually return to normal within a few months.” 

She cites a study published in the journal Human Reproduction that found that time to pregnancy was similar between former COC users and women who had never used hormonal contraception.

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