How long can I safely take birth control pills?
Answer From Yvonne Butler Tobah, M.D.
As long as you are generally healthy, you can safely take birth control pills for however long you need birth control or until you reach menopause. This applies to both combination estrogen-progestin and progestin-only birth control pills.
However, certain health conditions increase the risk of using estrogen-containing birth control pills. Throughout your lifetime and as you age, there may be times when estrogen-containing pills aren't recommended. For example, your doctor may recommend another form of birth control if you:
- Are a smoker age 35 or older
- Have just given birth
- Have a blood-clotting disorder, uncontrolled high blood pressure, certain heart or blood vessel problems, breast cancer, certain liver problems, gallbladder disease, migraines with aura, lupus, prolonged diabetes or complications from diabetes
Progestin-only pills appear to be a safe alternative for many women who can't use estrogen-containing birth control pills due to one of the conditions listed above. Like estrogen-containing pills, progestin-only pills may not be recommended for women who have breast cancer or certain liver problems.
Taking birth control pills may decrease the risk of certain types of cancer. For example, taking either type of birth control pill may decrease the risk of endometrial cancer. And estrogen-containing birth control pills may decrease the risk of ovarian cancer and colorectal cancer.
On the other hand, research suggests that long-term use of estrogen-containing birth control pills is associated with an increased risk of cervical cancer. This risk increases the longer you take the pills. But once you stop taking the pills, the risk of cervical cancer begins to decline. Approximately 10 years after stopping birth control pills, cervical cancer risk returns to the same level as for women who have never taken birth control pills.
The effect of estrogen-containing birth control pills on breast cancer risk isn't clear. Some research indicates that taking estrogen-containing birth control pills slightly increases the risk of breast cancer — but that 10 or more years after stopping the pills, breast cancer risk returns to the same level as for women who have never taken birth control pills. Other studies don't support a link between estrogen-containing birth control pills and breast cancer.
Progestin-only pills don't appear to affect the risk of cervical cancer or breast cancer.
Taking an occasional break from birth control pills offers no benefits and may increase the risk of blood clots or unintended pregnancy. If you're concerned about long-term use of birth control pills, discuss the risks and benefits with your health care provider. He or she can help you weigh the pros and cons of other types of contraception as well.
Yvonne Butler Tobah, M.D.
Jan. 28, 2020
- Hatcher RA, et al., eds. Contraceptive Technology. 21st ed. Ayer Company Publishers; 2018.
- Hatcher RA, et al. Managing Contraception 2019-2020: For your pocket. 15th ed. Bridging the Gap Foundation; 2020.
- Oral contraceptives and cancer risk. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Risk/oral-contraceptives. Accessed Oct. 14, 2019.
- AskMayoExpert. Contraception. Mayo Clinic; 2019.
- Bartz DA, et al. Combined estrogen-progestin contraception: Side effects and health concerns. https://www.uptodate.com/contents/search. Accessed Oct. 28, 2019.