Long-Term Birth Control: Are There Any Risks To Prolonged Use?

In 2022, the Supreme Court rocked the nation with its decision to overturn Roe v. Wade, which had promised American women the right to safe and legal abortion services for nearly 50 years. In the following months, as half of the population was forced to adapt to a new normal in which these services may be highly restricted or altogether prohibited, depending on where you live, the conversation surrounding the importance of birth control has taken center stage.

In the years leading up to the Supreme Court decision, information about the risks involved with the long-term use of birth control had been spreading, and clearly resonating. A survey commissioned by Cosmopolitan and Power to Decide revealed that in 2018, 70% of women taking birth control pills either discontinued using them or at the very least, considered it. However, doctors report that in response to the overturning of Roe V. Wade, patient requests for longer-lasting forms of birth control have once again been on the rise (per CNN). And while birth control is generally considered safe for most women, many still remain skeptical about the potential health risks.

Risks associated with long-term use of estrogen-containing birth control

In most cases, the benefits of birth control far outweigh their potential health risks. Regardless, it's important to understand that some risk does exist. While condoms, diaphragms, and sponges are tried and true non-hormonal forms of birth control, many women prefer to use more effective and longer-lasting options, like the pill, patch, or ring, which employ the use of estrogen to avoid ovulation (via the Cleveland Clinic). However, estrogen-containing birth control options can increase the risk of blood clots, particularly in women who are pregnant or who have recently given birth. In fact, those who have a history of blood clots, or a genetic or heart condition make developing blood clots more likely.

What's more, the National Cancer Institute points out that women who use the pill for long periods of time are at higher risk of developing breast and cervical cancers and the risk continues to grow the longer you use it. A 2003 study published in Lancet reported that using the pill for less than five years increased the risk of cervical cancer by 10% while using it between five and nine years increased the risk by a whopping 60%. Luckily, the risk begins to decrease again upon stopping using the medication, but for people who are already at an elevated risk of getting these types of cancers, it may be best to seek an alternative method altogether (via the National Cancer Institute).

Risks of progesterone based birth control

For women with an increased risk of blood clots and certain kinds of cancers, birth control containing estrogen may not be the best option. They may opt, instead, for the birth control shot, which is another form of hormonal birth control that uses progesterone, explains the U.S. Food & Drug Administration (FDA). While the birth control shot is an effective option, its extended use has been discouraged by the FDA due to its ability to weaken bones. Because the progesterone-containing shot contributes to the notable loss of bone mineral density, the FDA warns against using the shot for longer than two years. Much like the estrogen-containing birth control options, however, the negative effects that may be caused by the progesterone shot could potentially be reversed once you are no longer receiving the shot (per American College of Obstetricians and Gynecologists ).

All in all, the long-term use of hormonal birth control is still considered to be safe, although it does contain some level of risk (via GoodRx Health). For some women, you might try looking into ovulation tracking as a means to avoid pregnancy. However, as always, consult with your doctor before making any changes.