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Can I Use Birth Control Pills With Other Medical Conditions?

Birth control pills are one of the most widely used methods to prevent an unintended pregnancy and treat health issues related to female hormones. But a common question that arises is: can birth control pills be used safely by women who have other existing medical conditions?

This blog explains how birth control pills work and how existing health conditions or medications can influence whether a woman can use the pills safely. It also outlines the situations in which the pills may not be a suitable choice, and what alternative methods may be considered instead.

Key Takeaways:

  • Birth control pills, also known as oral contraceptive pills, are hormonal medications taken daily to prevent an unintended pregnancy. These pills contain synthetic versions of the natural female hormones estrogen and progesterone.

  • There are two main types of birth control pills - combined oral contraceptive pills (COCPs), which contain both estrogen and progestin (the synthetic form of progesterone), and progestin-only pills (POPs), which contain only progestin.

  • Women with health conditions like high blood pressure, migraine with aura, blood clots, liver disease, breast cancer, heart disease, or diabetic complications should avoid pills that contain estrogen. These conditions increase the risk of serious problems like stroke or heart attack.

  • Medicines for tuberculosis, epilepsy, HIV, or mood disorders can interfere with birth control pills and make them less effective. Women taking these medicines may need to use backup protection like condoms or switch to a non-hormonal method.

What are Birth Control Pills?

Can I Use Birth Control Pills With Other Medical Conditions? What are Birth Control Pills? Medical Conditions That May Make Birth Control Pills Unsafe to Use High Blood Pressure or Hypertension Migraine With Aura History of Blood Clots or Stroke Liver Disease Breast Cancer Diabetes Heart Disease Medications that Can Make the Pill Less Effective

Birth control pills, also known as the oral contraceptive pills, are hormonal medications taken daily to prevent an unintended pregnancy. These pills contain synthetic versions of the natural female hormones estrogen and progesterone.

There are two main types of birth control pills - combined oral contraceptive pills (COCPs), which contain both estrogen and progestin (the synthetic form of progesterone), and progestin-only pills (POPs), which contain only progestin. COCPs are the most commonly used type of birth control pills, whereas POPs are usually recommended for women who cannot take estrogen due to medical reasons.

The hormones present in the pill prevent pregnancy mainly by stopping ovulation, which means no egg is released for fertilisation by sperm. The pill also thickens the mucus at the cervix (opening of the uterus), making it harder for the sperm to travel to the egg. The pill also thins the inner lining of the uterus so that a fertilised egg is less likely to attach to the lining and develop into a pregnancy.

Birth control pills must be taken daily at around the same time. These are over 99% effective when used correctly and consistently.

Medical Conditions That May Make Birth Control Pills Unsafe to Use

Can I Use Birth Control Pills With Other Medical Conditions? What are Birth Control Pills? Medical Conditions That May Make Birth Control Pills Unsafe to Use High Blood Pressure or Hypertension Migraine With Aura History of Blood Clots or Stroke Liver Disease Breast Cancer Diabetes Heart Disease Medications that Can Make the Pill Less Effective

High Blood Pressure or Hypertension

Women with uncontrolled or moderate-to-severe high blood pressure (140/90 mmHg or higher) are usually advised not to take combined oral contraceptive pills. This is because the estrogen in these pills can raise blood pressure further and increase the risk of heart attack or stroke.

If blood pressure is only mildly raised and well-controlled with treatment, some doctors may still prescribe combined pills with careful monitoring. In many cases, however, progestin-only pills are considered safer for women with hypertension.

Migraine With Aura

Migraines are a type of severe headache. They often cause throbbing pain on one side of the head and may come with nausea, vomiting or sensitivity to light and sound. Some people experience something called an aura before the migraine begins. An aura is a warning sign that can include flashing lights, zigzag lines, blurry vision, numbness in the face or hands, or trouble speaking. These symptoms usually last for a few minutes to an hour before the headache starts.

Women who get migraines with aura have a higher risk of stroke. This is because both the migraine and the estrogen in combined oral contraceptive pills can increase the chances of blood clots forming in the brain. For this reason, COCPs are generally not recommended for women with migraine with aura. POPs may be a safer choice in such cases, but a doctor will assess the risks and suggest the best option.

History of Blood Clots or Stroke

A history of deep vein thrombosis (DVT), pulmonary embolism, stroke, and other clotting disorders makes combined oral contraceptive pills unsafe to use. Estrogen can increase the tendency of blood to clot, which can be dangerous in women who are already at higher risk.

For women with a personal or strong family history of clotting conditions, progestin-only methods or non-hormonal options like a copper intrauterine device (IUD) may be considered.

Liver Disease

The liver helps metabolise (break down) the hormones in birth control pills. Women with active liver disease, liver tumours, or conditions like cirrhosis should not use hormone-containing pills. The added strain on the liver can worsen liver function or lead to complications. For these women, non-hormonal methods or options that do not rely on liver metabolism are usually recommended.

Breast Cancer

Can I Use Birth Control Pills With Other Medical Conditions? What are Birth Control Pills? Medical Conditions That May Make Birth Control Pills Unsafe to Use High Blood Pressure or Hypertension Migraine With Aura History of Blood Clots or Stroke Liver Disease Breast Cancer Diabetes Heart Disease Medications that Can Make the Pill Less Effective

Birth control pills are usually not recommended for women who currently have breast cancer or have had it in the past. The estrogen and progestin contained in the pill may encourage the growth of hormone-sensitive breast cancers. Even in women at high genetic risk of developing breast cancer, such as those with BRCA1 or BRCA2 mutations, alternative methods of contraception may be recommended. This precaution also applies to women with unexplained breast lumps or abnormal mammogram results until further tests are done.

Diabetes

Women with diabetes without complications can usually take combined oral contraceptive pills. However, if diabetes has caused complications, such as damage to the kidneys, eyes, or blood vessels, then estrogen-containing pills may not be recommended. This is because such women are at greater risk of heart disease and stroke, which can be worsened by estrogen. For these women, progestin-only pills or non-hormonal methods may be more suitable.

Heart Disease

Women with known heart disease, heart wall (valvular) disease, or irregular heartbeat (arrhythmia) are generally advised not to use combined oral contraceptive pills. Estrogen can increase the risk of clotting and raise blood pressure, both of which can worsen heart conditions. Women with heart conditions are usually recommended progestin-only pills or non-hormonal methods.

Medications that Can Make the Pill Less Effective

Can I Use Birth Control Pills With Other Medical Conditions? What are Birth Control Pills? Medical Conditions That May Make Birth Control Pills Unsafe to Use High Blood Pressure or Hypertension Migraine With Aura History of Blood Clots or Stroke Liver Disease Breast Cancer Diabetes Heart Disease Medications that Can Make the Pill Less Effective

Certain medicines can interfere with the way birth control pills work, especially by reducing hormone levels in the body. This can make the pill less effective and increase the risk of an unintended pregnancy.

The most well-known medicines that affect birth control pills include:

  • Rifampicin: An antibiotic often used to treat tuberculosis.

  • Anticonvulsants: Medicines like phenytoin, carbamazepine, and phenobarbital, used to control epilepsy.

  • Some anti-HIV drugs: Medicines, like ritonavir and nevirapine, which are used to help control HIV infection.

  • St John's Wort: A herbal supplement used for mild depression or mood swings.

When taken together with birth control pills, these medicines can speed up how quickly the body breaks down the hormones contained in the pills, making the pills less effective. In such cases, additional birth control methods such as condoms or a non-hormonal IUD may be recommended.

Conclusion

Birth control pills are a safe and effective method of preventing an unintended pregnancy for many women. However, certain medical conditions and medications can make these pills, especially combined oral contraceptive pills, unsafe or less effective. In cases where combined oral contraceptive pills are not safe, progestin-only pills or non-hormonal methods may be better suited.

Medical advice is essential in making this decision, especially for women living with chronic health issues or taking long-term medications. A doctor can assess a woman’s full medical history before prescribing any form of contraception.

Frequently Asked Questions (FAQs)

  • Can women with lupus take birth control pills?

    Some women with lupus may take birth control pills, but it depends on whether the condition increases the risk of blood clots. If the woman has antiphospholipid antibodies (linked to clotting problems), estrogen-containing pills are generally avoided. Medical guidance is essential in making this decision.

  • Is it safe to use birth control pills with thyroid problems?

    Most women with thyroid conditions can safely use birth control pills. However, hormone levels may affect how thyroid medicines work, so dosage adjustments may be needed. Regular monitoring is recommended. Medical guidance is essential in deciding whether birth control pills may be safe to use.

  • Can women with epilepsy take birth control pills?

    Some epilepsy medicines can reduce the effectiveness of birth control pills. In such cases, a different contraceptive method or a higher-dose pill may be required. Consultation with both a neurologist and a gynaecologist is important in making this decision.

  • Can birth control pills be used by women with kidney disease?

    Women with severe kidney disease or those on dialysis may be advised to avoid estrogen-containing pills, as these can increase blood pressure and clotting risks. Safer alternatives may include progestin-only methods. Medical guidance is essential in making this decision.

  • Is it safe to take birth control pills while breastfeeding?

    Combined oral contraceptive pills may reduce milk supply during breastfeeding. Progestin-only pills are generally preferred during this time, especially in the first few weeks after delivery.

Important

This blog, including its text, images, and infographics, is for educational purposes only and not a substitute for professional medical advice. For personalised advice, always consult a doctor.

Further Reading

For more details on this or related topics, refer to the papers listed in references below, or check out the other blogs on our website dulycare.in.

References

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