Birth Control Pill and Patch, how safe are they?
June 3 2017 by
Ray Sahelian, M.D.

The risk of side effects from newer birth control pills may be higher than previously thought. Some newer birth control pills carry a much higher risk of dangerous blood clots as older contraceptives. These, which include several made by Barr Pharmaceuticals Inc. and Akzo Nobel NV unit Organon BioSciences, are also no better than some older ones, according to Public Citizen, which filed a petition filed with the Food and Drug Administration.
Millions of prescriptions have been filled for birth control pills, which includes Johnson & Johnson's Ortho-Cept and Watson Pharmaceuticals Inc.'s Reclipsen. The petition also mentioned Barr's Mircette, Velivet, Kariva as well as Organon's Desogen. Generic birth control pills containing desogestrel were also cited. Older oral contraceptives contain estrogen and progestin hormones, but newer ones sold in the United States -- so-called "third generation" -- contain a different type of progestin called desogestrel. "By banning third-generation oral contraceptives, the FDA will potentially save hundreds of young women a year from developing venous thrombosis and its disabling and sometimes fatal consequences," said Public Citizen.

Q. What is your take on birth control contraception pills. I was born at the beginning of the 1970s and I clearly remember woman's magazines clearly praising how wonderful they are basically solving any problems form PMS syndrome to bad acne. At the same time i do not remember at the time ANY young women under 40 to have to worry about breast cancer or ovarian cancer or any other cancers that i seem to hear more and more appearing in girls even around age 20. I took the pill for a very short period of time in my twenties. I could not obviously tie the two together but at the same time i also had extreme mood-swings and gained a lot of weight. I got off of them. Since than i was not taking them (especially after about 10 years ago an old school mate of mine died at the age of 24 after giving birth to her first child and returning to the pill), lost the weight, got over most of the emotional stuff. Recently however it became obvious to me that i would need to come up with a fairly reliable contraceptive method. I heard new pills are "safer" than the old ones 10-15 years ago, but somehow i have hard time trusting it. Nowadays these drugs are handed out like vitamins and that makes me very uncomfortable. What is your take on the birth control contraception pills?
   A. I don't like introducing hormones into women's or men's bodies at any age, particularly at a young age, unless absolutely required.

Birth control pill side effect and long term danger - increased risk for breast cancer
The most serious birth control pill side effect is a blood clot. The blood clot can occur throughout the body and dislodge to block blood flow to the lungs and other crucial organs. Those that contain the hormone drospirenone must now carry a warning. Other common side effects of birth control pills include: Bleeding or spotting between menstrual cycles. Nausea. Tender breasts. Gaining weight or retaining water. Darkened spots on the skin. Moodiness.
   Postmenopausal women who use combination hormone replacement therapy (HRT) containing estrogen and progestin have an increased risk of breast cancer if they also have a history of birth control pill use.
   The use of a combination oral estrogen-progestin birth control pills by otherwise healthy young women increases the prevalence of carotid and femoral artery plaques by 20% to 30% for every 10 years of use.
   Women who take birth control pills run a higher risk of developing cervical cancer, but this risk is transient and reverts to normal about 10 years after they stop.
   Oral contraceptives behave differently in the bodies of obese women than in normal-weight women, they may not work as well in preventing pregnancy. Contraception, 2009.

Newer forms of the birth control pill -- brands such as Yaz, Yasmin and Desogen -- are more likely to cause blood clots than older versions.

Hum Reprod. 2013. Heparanase procoagulant activity is elevated in women using oral contraceptives.

Risk of blood clot
Thrombotic risk is associated with the estrogen dose and type of progestin in combined oral contraceptives. Studies published since 1990 show that third-generation progestins have larger risk to contribute to thrombosis development than the second-generation.

Birth control patch carries higher side effect risk
The risk of blood clots in the legs and lungs may be higher for women using the birth control patch. The label on the Ortho Evra birth-control patch has been updated to reflect the results of a study that found women using the birth control patch faced twice the risk of clots than did women on the pill. However, a second study found no difference in risk between the two forms of birth control. Initial results of the two studies were made public in February by the patch's manufacturer, Ortho Women's Health & Urology. The Raritan, N.J.-based company is owned by Johnson & Johnson. In 2005, an investigation by The Associated Press, citing federal death and injury reports, found higher rates of blood clots in women using the patch. In November, 2006 the FDA updated the label on Ortho Evra to alert women that using the birth control patch exposes them to about 60 percent more estrogen than using birth-control pills. Ortho Women's Health & Urology reported in filings made in August 2006 that Ortho Evra sales have declined significantly following the previous label revision and a spate of media coverage of the clot issue. Since the birth control patch went on sale in 2002, more than 4 million women have used it. The company also disclosed that approximately 500 people have filed lawsuits or made claims related to injuries they allegedly suffered from the Ortho Evra patch. The investigation by The Associated Press found that patch users die and suffer blood clots at a rate three times higher than women taking the pill. About a dozen women died in 2004 from blood clots believed linked to use of the patch. Dozens more suffered strokes and other clot-linked problems.

Bone mass while weight lifting
Young women who use oral contraceptives may not get as much out of their weight-lifting routine as women who are not on the pill. Chang-Woock Lee, from Texas A&M University in College Station identified a potential new factor that may be independently associated with the characteristics and variability of muscle responses to a controlled resistance exercise training program. Chang-Woock Lee did a study with 73 healthy women between 18 and 31 years old. They participated in whole-body resistance exercises three times a week for 10 weeks. Thirty-four of the women used oral contraceptives and 39 did not. The women were encouraged to eat enough protein to promote muscle growth. There were marked differences in lean muscle mass gains between the two groups. Lean muscle increased by just 2.1 percent in birth control pills users compared with 3.5 percent in non users. Blood levels of three muscle-building hormones were lower and one muscle-breaking hormone was significantly higher in oral contraceptive users than non users. The findings were presented at the American Physiological Society meeting, 2009, in New Orleans.

Ortho Evra Contraceptive Transdermal Patch
2008 - The label on the Ortho Evra Contraceptive Transdermal Patch will need to include the results of a study in women aged 15-to-44 indicating a higher risk of clots than for women using birth control pills. These could potentially lead to a lung embolism.

The so-called morning-after pill, an emergency contraceptive, is going over-the-counter, with the U.S. Food and Drug Administration announcing that it has approved unrestricted sales of Plan B One-Step.

Supplements and interactions, combination with herbs and vitamins
Q. I am wondering if you have any information or know of any research done on using supplements to assist in mood swings related to hormonal birth control. I have been told that both Calcium and B-6 can help if taken daily.
   A. It is difficult to say which supplements will for a particular person, but in general you may wish to discuss some of the options mentioned on the page on depression such as 5-htp or fish oils or kava or passion flower, etc. with your doctor.

Q. I'm an currently on birth control pill, will the Passion Rx affect the birth control pill taking? How often should I take Passion Rx? Just whenever or when I am about to have sex that day?
   A. Many sex herbs work better on the second day of use, therefore it may be better to take Passion Rx the day before and perhaps a smaller amount the day of sexual activity. If you have sex let's say on the weekends, you could skip taking Passion Rx during the week and just take it on Friday and Saturday. These are general guidelines and each person through trial and error will find the best time and dosage for them.

Q. I was wondering if maca herb interferes with birth control at all. I am on ortho tri cyclin and i do not want to take anything that would make it less effective.
   A. We have not seen any studies that have looked at the interaction of maca herb with birth control pills. We doubt a maca supplement would interfere with birth control pills, but we can't be sure since we are not aware of medical studies combining the herb and the hormone.

Q. I am 55 years old. In my mid 40's I started getting horrible migraines once a month when I would go off the pill. I was still on birth control pills at the time and my woman gynecologist told me to take the pill for two months and then I would only have a migraine once every two months when I went off for a cycle. What a crock. I didn't even try that. I read your book on pregnenolone so I started taking 30 mgs a day and went off the birth control pill. I had no more migraines to this day and I have been through menopause with ease.
   A. Thanks for writing and I am very glad you were helped. Since writing my book on pregnenolone I have realized that this hormone is much more potent than I thought and now my dosages recommendations are a fraction of what I had mentioned before. So, use the least amount that works for you.

Can I take maca herb while I am on birth control?
    We can't specifically assure that any herbal and hormonal combination is safe in any one person, but thus far we have not had any reports of untoward reactions with maca and this combination.