Birth Control Pills: A Guide for Parents

If your child has recently started taking birth control pills or is thinking about taking them, you probably have some questions and worries of your own. Teens and young adults are frequently prescribed birth control pills (also called oral contraceptive pills, hormonal pills, or simply “the Pill”) for conditions such as irregular or heavy menstrual periods, menstrual cramps, acne, PMS, Primary Ovarian Insufficiency (POI), endometriosis, and hormone replacement therapy. For example, teens diagnosed with Polycystic Ovary Syndrome (PCOS) – a hormone imbalance which causes irregular menstrual periods, acne, and excess hair growth, are prescribed birth control pills to lower their hormone levels (to the normal range) and regulate menstrual periods. Teens with acne that are not responding to simple measures are often prescribed birth control pills. Teens whose ovaries are not producing enough estrogen (due to the effects of radiation or chemotherapy, a genetic condition such as Turner Syndrome, or stress) may take birth control pills to replace estrogen. If the lack of periods are caused by low weight or an eating disorder, the best treatment is healthy nutrition to restore a normal weight. Teens with endometriosis are also often prescribed birth control pills, in cycles or continuously, to suppress the condition. Normal estrogen levels and healthy weight are important for healthy bones. Last but not least, birth control pills are used for birth control.

Does the birth control pill have health benefits?

Yes. The Pill has many health benefits, such as:

• Regulation of menstrual periods
• Decreased menstrual cramps
• Treatment for acne
• Treatment for polycystic ovary syndrome (PCOS)
• Lowered risk of anemia
• Lowered risk for cancers such as ovarian and uterus cancer

Are there any serious side effects from the Pill?

Most teens who take birth control pills have few or no problems. However, birth control pills with estrogen cause a slight increase in the risk of developing blood clots in the legs, eyes, and lungs. If your child develops any of the following problems, call their health care provider right away or take them to the closest emergency room:

• Abdominal or stomach pain (severe)
• Chest pain (severe), cough, shortness of breath
• Headache (severe), dizziness, weakness, or numbness
• Eye problems (vision loss or blurring), speech problems
• Severe leg pain (calf or thigh)

Remember: ACHES

Does the birth control pill cause blood clots?

There is a very slight risk of developing blood clots in the legs, but this risk is far less than the risk during pregnancy. Among teens who do not take the Pill, 1-10 in 100,000 will develop blood clots each year. Among teens who take combined oral contraceptive pills, the risk increases 3-5 fold or to 5-50 per 100,000 per year. For those who are pregnant, the risk of developing blood clots is twice as high as Pill users and 4-10 fold compared to nonusers.

Is there any way my child can lower her risk of getting blood clots while taking the Pill?

Make sure you let your child know (and their health care providers) if any of their blood relatives have had blood clots, especially when they were young (in their 20s, 30s, or 40s). There are other factors that can contribute to the likelihood of whether a teen develops blood clots such as a diagnosis of Factor V Leiden, trauma, or surgery, being overweight and smoking.

If your child smokes, encourage them to quit. If they are planning a flight or long car ride (especially if 6-8 hours or longer), remind them to get up and walk around and drink lots of fluids to lessen the risk of blood clots. If they are having surgery (and will be immobilized and on bed rest for a period of time), talk to their health care provider about whether they should go off the Pill 3-4 weeks before the surgery.

Does the birth control pill cause heart attacks or strokes?

There is no significant increase in the risk of heart attack or stroke in healthy teens who take birth control pills and don’t smoke. If your child is a smoker, encourage them to quit smoking. They can still take the Pill if they smoke, but if they quit smoking, they’ll be healthier for life and their risks from taking the Pill will be less.

Does the birth control pill cause cancer?

The truth is that the Pill actually protects against cancer of the ovaries and cancer of the lining of the uterus. A teen is half as likely to get cancer of the uterus or ovaries if they have taken birth control pills. Most experts believe that taking the Pill does not cause any increased risk of getting breast cancer. Even teens with a family history of breast cancer can take the Pill.

Does the birth control pill cause birth defects?

Birth control pills do not cause birth defects or affect the health of future children.

Is there any trouble getting pregnant after using the birth control pill?

There is no change in fertility with using the birth control pill. Regular periods and ovulation usually start up again right away. However, teens who were very irregular before starting the pill may be irregular after they stop the pill. Teens who have PCOS or lose weight on the pill are particularly likely to be irregular, not because of the Pill, but because of their medical condition.

If your child was using the Pill for birth control, they should use another birth control method right away, if they don’t want to get pregnant. They should talk to their health care provider before they actually stops taking the birth control pill.

How long is it safe for my child to be on birth control pills?

It’s safe for your child to be on the Pill for years, whether they are on it to regulate their menstrual cycles, cramps, hormone replacement, or if they are simply using it for birth control.

Does my child need to take a break from the Pill?

There is no medical reason that your child would need to take a “break” from the Pill. There are no medical benefits from taking a break. If your child was to stop taking the Pill and then go on it again, they could have the same side effects that they already experienced during the first few months of pill use. In addition, your child would not experience the many medical (non-contraceptive) benefits that the Pill offers.

Will my child gain weight from taking birth control pills?

It’s unlikely that your child will gain weight on the Pill. Research studies have not shown a consistent connection between birth control pills and weight gain. Some teens gain weight, some lose weight, but most teens stay exactly the same weight when they are taking the birth control pill. Sometimes a teen thinks they has gained 5-10 pounds, but when weight is actually measured, there’s no change. If your child thinks they may have gained weight due to the Pill, they should see their health care provider and get their weight measured. Encourage your child to eat a healthy diet. Suggest that they eat 5-7 servings of fruits and vegetables a day, eat normal portion sizes, avoid fast foods and simple carbohydrates such as cookies, cake, sugary cereal, etc. Also, encourage them to be active and exercise or take part in an activity that they enjoy.

Will the birth control pill have any negative effects on my child’s growth?

No, the birth control pill should not affect or hinder your child’s growth if they have already started their period. By the time they have their first period, they are already at 95% of their final height.

Will the Pill make my child’s cramps better?

For teens who experience severe menstrual cramps and over-the-counter medications do not help, birth control pills may be the solution. Birth control pills can help to decrease menstrual cramps. Because the combined birth control pills prevent ovulation, they also get rid of pain that your child may experience with ovulation in the middle of their menstrual cycle.

Will the Pill make my child’s menstrual periods more regular?

For teens whose menstrual periods are irregular (too often or too late), birth control pills can help to regulate the menstrual cycle to every 28 days. Birth control pills can also reduce the amount and length of menstrual bleeding.

What if my child’s period is very light while they’re taking birth control pills?

Your child’s period may be so light when they are taking birth control pills that they may only have a brown smudge on a tampon, pad, panty shield, or underwear. The hormone doses in birth control pills are very low. This means that the lining of your child’s uterus doesn’t become very thick, so very little blood needs to come out each month.

Will the birth control pill make my child’s acne better?

Birth control pills usually improve acne. For moderate to severe acne, which over-the-counter and prescription medications haven’t cured, birth control pills may be prescribed. The hormones in the birth control pill may help stop acne from forming. It doesn’t usually matter which type of birth control pills your child takes, since they all typically have the same effect at minimizing hormonal acne. Encourage your child to be patient though, since it may take several months to see a difference with their acne.

What if my daughter has PCOS? How do birth control pills help?

If your child has PCOS, you’re probably already aware that PCOS can cause irregular menstrual cycles, excess hair growth, and acne. One of the treatments prescribed for PCOS are birth control pills (oral contraceptives), because the hormones (estrogen and progestin) in the pill regulate menstrual cycles. Birth control pills allow the endometrial lining to be shed. Because birth control pills cause teens to menstruate regularly and shed the endometrial lining on time, they reduce the risk of endometrial cancer. Birth control pills also improve acne and lessen excess hair growth, which is another reason they are used to treat PCOS.

What if my child has endometriosis? How do birth control pills help?

Hormonal treatment such as birth control pills either taken in cycles or continuously are felt to relieve symptoms associated with endometriosis in 8 out of 10 patients. The Pill does not cure endometriosis, but when prescribed continuously, it will stop your child’s period along with the pain that is often associated with it and lessen the chance of the endometriosis growing.

Will my child start having sex if they go on birth control pills for acne or any other medical reason?

Your child will most likely not start having sex if they go on the Pill for reasons other than birth control. If they go on the Pill for one of the medical reasons, they are probably just thinking about treating whatever the problem is. Their decision to have sex will likely be completely independent from their decision to go on the Pill at this time. Your child will choose to start having sex when they are ready, which involves much more than just when birth control is available.

What other medical benefits does the pill have?

Because there is less menstrual bleeding with the use of birth control pills, your child is less likely to get anemia (low number of red blood cells, which carry oxygen from the lungs to the tissues). Birth control pills also decrease the chance of getting endometrial (lining of the uterus) cancer, ovarian cancer, and ovarian cysts.

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