What Are the Long-term Side Effects of Birth Control?

Birth control is a common way to prevent pregnancy, and treat some medical conditions. If you've been on birth control for much of your adult life, you may wonder if taking birth control for years, or even decades, is safe. 

Most serious side effects from birth control are rare. Still, you’ll want to consider long-term side effects if you plan to use birth control for many years. Here, we’ll talk about the potential long-term side effects of birth control and if there's such a thing as being on birth control for too long.

What are the different types of birth control?

Birth control methods can be divided into two categories: hormonal and non-hormonal. Hormonal methods are commonly used, and what we’ll focus on in this article. Non-hormonal methods include barrier methods, like condoms. The copper intrauterine device (IUD) also doesn't contain any hormones. 

What are the most common hormonal birth control methods?

Hormonal birth control methods contain estrogen and progestin, or just progestin alone. Progestin is a lab-made version of the hormone progesterone. When a product has an estrogen and progestin, it’s called a “combination” birth control method. Combination birth control methods include:

• Birth control pills, like ethinyl estradiol/drospirenone (e.g., Yaz) and ethinyl estradiol/norgestimate (e.g., Sprintec) 

• Xulane (norelgestromin and ethinyl estradiol) patch 

• Nuvaring and Eluryng (ethinyl estradiol/etonogestrel) vaginal rings 

• Annovera (ethinyl estradiol/segesterone acetate) vaginal ring

Other hormonal birth control methods contain progestin only. These include:

• Birth control pills like norethindrone (Errin) and drospirenone (Slynd) 

• Depo-Provera (medroxyprogesterone) injection 

• Nexplanon (etonogestrel) arm implant

• Levonorgestrel (e.g. Mirena) IUDs

Are there long-term side effects of birth control?

Serious side effects of hormonal birth control are possible, though it’s rare. Most of the information we have about long-term side effects of birth control is for oral birth control, so we'll focus on birth control pills for most of this discussion.

Below, we’ll go through some of the potential side effects that can cause serious health concerns.

Blood clots

Blood clots can happen in your arms or legs (called deep vein thrombosis, or DVT). These clots can break off and travel to the lungs (pulmonary embolism). A review of 26 studies looked at whether people taking combination birth control pills had a higher risk of DVT. The review included 10 different kinds of combination pills. Every pill studied raised the risk of blood clots. Certain types of progestins — like desogestrel and drospirenone — raised the risk of blood clots more than levonorgestrel (another type of progestin).

Still, the risk of blood clots with hormonal birth control pills is very small. In fact, pregnancy itself raises your risk of blood clots more than taking birth control pills.

If you have a history of blood clots, an IUD containing levonorgestrel may be a better option than birth control pills. If you have any questions or concerns, talk to your healthcare provider about the risk of blood clots with birth control pills.

Heart attack and stroke

Blood clots can travel to the heart, blocking off blood supply and causing a heart attack, or travel to the brain and cause a stroke. In a review of 24 studies, the risk of heart attack or stroke was higher in people taking birth control pills. The risk was highest for pills that contained 50 mcg of estrogen or more.

Keep in mind that heart attacks in women younger than 50 years of age are rare. Many people stop birth control pills around this age as they enter menopause. Still, let your healthcare provider know if you have a history of heart disease, high blood pressure, or you've had a previous stroke. It’s possible that the levonorgestrel IUD is a better option if you’re at high risk for heart attack or stroke.

You should also let your provider know if you smoke cigarettes. Hormonal birth control pills are not recommended in women who smoke cigarettes and are 35 years of age or older because the risk of stroke or heart attack is higher in this population.

Cancer

Oral birth control pills may raise your risk of certain cancers, including breast and cervical cancers. But birth control pills can also lower the risk of other cancers like endometrial, ovarian, and colorectal cancers. 

Breast Cancer

All birth control pills can raise the risk of breast cancer. In one study of over 150,000 people, the risk of breast cancer was higher while taking combination pills. The risk remained elevated in the 10 years after stopping the pills. After 10 years without the pills, the risk returned to normal.

Another study looked at 1.8 million people on combination pills and other types of hormonal birth control methods like the patch, vaginal ring, and levonorgestrel IUD. The study found that all hormonal birth control methods included in the study raised the risk of breast cancer.

A third study looked to see if the breast cancer risk differed among the different types of hormonal birth control. Researchers found that the risk was similar, regardless of whether women took combination or progestin-only birth control.

But it’s important to put these results in perspective, because the risk is still very low, especially for young women. Out of 100,000 adolescents ages 16 to 20 using hormonal birth control, only 8 more than what’s typical for the general population would be expected to develop breast cancer. For women ages 25 to 29, this risk is about 61 of 100,000 women. And for women ages 35 to 39, the risk is about 265 of 100,000 women.

These risks are based on women who used hormonal birth control for 5 years and then stopped. Their risks for breast cancer (while small overall) were greater while taking birth control and remained elevated for 10 years after stopping.

Cervical cancer

A World Health Organization (WHO) study found that cervical cancer was more likely in people who took birth control pills for at least 5 years. The study also found that the longer you use birth control pills, the higher your risk is. But, your risk likely returns to normal levels after you stop birth control. The study only looked at people who had the human papilloma virus (HPV), because the virus is a primary cause of cervical cancer.

Endometrial, ovarian, and colorectal cancers

Though hormonal birth control methods may raise the risk of breast and cervical cancer, it may lower the risk of other cancers. A study of 46,000 people found that oral birth control lowered the risk of ovarian, endometrial, and colorectal cancer. This effect lasted for more than 30 years after stopping the medication. Other studies support these findings. 

In a review of over 50 studies, oral birth control lowered the risk of ovarian cancer. The risk was lowest for people taking birth control pills for over 10 years. Another review of 11 studies found that hormonal IUDs may lower the risk of ovarian cancer, too.

Studies of oral birth control and colorectal cancer have similar outcomes. In a study of over 90,000 women, oral birth control lowered the risk of colorectal cancer.

Lastly, oral birth control has been shown to lower endometrial cancer risk. In a study of over 100,000 people, oral birth control lowered the risk of endometrial cancer. This was especially true in people that smoked, had obesity, or rarely exercised. But in this study, oral birth control pills did not lower endometrial cancer risk in people with a body mass index (BMI) of 25 or less.

Can birth control pills affect my fertility?

When you’re ready to have a baby, you might wonder if years of hormonal birth control will affect your ability to get pregnant (fertility). Rest assured that current research indicates that prior use of birth control shouldn’t affect your fertility.

A review of 22 studies — and almost 15,000 people — found that fertility was not affected by prior use of birth control. Another study of almost 8,500 people also found that the chance of becoming pregnant was not lower in people who took birth control pills in the past. In fact, this study found that people taking oral birth control pills for 5 years or more became pregnant more quickly after stopping the pill. This could be because birth control can protect people from negative effects of some medical conditions, like endometriosis.

While birth control doesn’t affect your fertility, it may take time to become pregnant after stopping it. For most people, pregnancy occurs within 12 months after stopping birth control. But a birth control method like the Depo-Provera injection may lengthen the amount of time it takes to get pregnant.

How long is too long to be on birth control?

How long you wish to take birth control is a personal decision. Talk to your healthcare provider or pharmacist if you have concerns about your birth control or how long you’ve been on it. While birth control is generally safe, there’s some instances where you should avoid certain types of birth control. For example, if you’ve had a DVT in the past, and are at high risk of having one again, combination birth control pills aren’t recommended. The same is true if you have migraines with aura. 

Why trust our experts?

Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Our editorial standards

Meet our experts