8 Reasons Why Some Women Should Avoid Birth Control Pills
Birth control pills have transformed reproductive health, offering millions of women a convenient and effective means of preventing pregnancy. However, while they are widely used and generally safe for many, they are not a one-size-fits-all solution. Certain medical conditions, lifestyle factors, and risk profiles can make the pill unsuitable—or even dangerous—for some women.
In this article, we explore eight evidence-backed reasons why birth control pills may not be appropriate for everyone, highlighting when to consider alternative options and what to discuss with your doctor.
1. Risk of Blood Clots
One of the most serious potential side effects of hormonal contraceptives, particularly those containing oestrogen, is an increased risk of blood clots. These clots can lead to deep vein thrombosis (DVT), pulmonary embolism, or stroke. Women with a personal or family history of clotting disorders, or those who are immobile for long periods, should avoid oestrogen-based pills.
Key risk factors include:
- Smoking while over age 35
- Obesity or sedentary lifestyle
- Genetic clotting disorders (e.g. Factor V Leiden mutation)
2. Migraines with Aura
Women who experience migraines with aura (sensory disturbances like flashing lights) face a significantly higher risk of stroke when taking combined hormonal contraceptives. The oestrogen component can constrict blood vessels and increase blood clot risks in these women.
Recommendation: Progestin-only pills or non-hormonal methods like copper IUDs are usually preferred for migraine sufferers.
3. History of Breast Cancer
Birth control pills contain hormones that can influence oestrogen and progesterone receptors in breast tissue. For women with a history of breast cancer—or even a strong family history—these hormones can be a red flag.
Although the link between birth control and breast cancer remains debated, most oncologists err on the side of caution, especially for survivors or those with BRCA gene mutations.
4. Uncontrolled High Blood Pressure
Hormonal contraceptives can raise blood pressure in some women, and those with pre-existing hypertension are at a higher risk of cardiovascular events. Birth control pills are generally contraindicated in women with poorly controlled or severe hypertension.
Tip: Always monitor blood pressure regularly while on the pill, especially if you’re over 35 or have a family history of heart disease.
5. Liver Disease
The liver metabolises the hormones in birth control pills. Women with active liver disease—including cirrhosis, liver tumours, or hepatitis—may struggle to process these hormones properly, potentially worsening their condition.
In such cases, doctors often recommend barrier methods or intrauterine devices (IUDs) that don’t rely on systemic hormone processing.
6. Smoking and Age Over 35
Smoking while using the pill dramatically increases the risk of cardiovascular problems, including heart attacks and strokes. This risk compounds with age, making the combination of smoking and being over 35 particularly dangerous.
Women in this category are often advised to quit smoking if they wish to continue hormonal birth control or to switch to non-hormonal options altogether.
7. Irregular Pill Use or Forgetfulness
The effectiveness of birth control pills depends heavily on consistency. Missing doses or taking them at irregular times increases the risk of unplanned pregnancy. For women who struggle with daily routines or travel frequently across time zones, long-acting reversible contraceptives (LARCs) like implants or IUDs may be more suitable.
Alternatives: Birth control injections (Depo-Provera), the patch, or a vaginal ring may offer more flexibility for women with busy lifestyles.
8. Susceptibility to Depression or Mood Disorders
Some women experience mood swings, anxiety, or depressive symptoms while on hormonal contraceptives. Although the link between birth control and mental health is complex and varies individually, women with a history of mood disorders should discuss risks with their provider.
In such cases, a trial period may be recommended, or a shift to a non-hormonal method can be considered if symptoms worsen.
Real-Life Example
Consider 36-year-old Rina, a smoker with a family history of stroke. After being prescribed a combined oral contraceptive pill, she began experiencing migraines with aura. Her doctor immediately switched her to a progestin-only pill and helped her access a smoking cessation programme. Within months, her migraines reduced, and she felt more in control of her health and fertility choices.
What Are the Alternatives?
If birth control pills aren’t suitable for you, there are many other safe and effective contraceptive options:
- Barrier methods: Condoms, diaphragms, and cervical caps.
- Non-hormonal IUD: Copper IUD provides long-term protection without hormones.
- Hormonal IUD or implant: Localised hormone release with fewer systemic effects.
- Fertility awareness methods: Tracking ovulation with care and discipline.
- Sterilisation: Tubal ligation for women or vasectomy for men as permanent options.
FAQs
Q: Can I take birth control pills if I have PCOS?
A: Yes, in many cases birth control pills are used to manage PCOS symptoms. However, individual risks (such as clotting) must still be evaluated.
Q: Are progestin-only pills safer?
A: They carry fewer risks than combined pills, especially for smokers, older women, or those prone to migraines or cardiovascular conditions.
Q: Do birth control pills cause infertility?
A: No. Fertility typically returns soon after stopping the pill. However, pre-existing conditions masked by the pill may emerge post-discontinuation.
Q: Is it dangerous to stop taking the pill suddenly?
A: No, but you should use another contraceptive method immediately if you don’t wish to conceive.
Internal Links for Further Reading
- Common Side Effects of Birth Control Pills
- Why Women Experience Hormonal Fluctuations
- Contraceptive Options Other Than the Pill
- Side Effects of IUDs
Conclusion
Birth control pills remain a reliable and convenient option for many women—but they're not ideal for everyone. Your health history, lifestyle, and risk factors all matter when choosing a contraceptive method. If you're unsure whether the pill is right for you, consult a healthcare provider to explore safer and more personalised alternatives. Informed choices lead to empowered decisions—especially when it comes to your reproductive health.