Is the birth control pill safe?
Q. I’ve heard about lawsuits concerning certain birth control pills. How do I know if the pill I’m taking is safe?
A. No birth control pill is 100 percent risk-free. And most birth control pills increase slightly the risk of blood clot and stroke - unless they are based entirely on estrogen rather than a combination of estrogen and progestin hormone. But pregnancy increases the risk of blood clot and stroke more than any of the birth control pills in widespread use.
“The risk of having a stroke is very low with the pill, and it’s still safer to be on the pill than it is to be pregnant,’’ said Dr. Daniela Carusi, director of general gynecology at Brigham and Women’s Hospital.
The recent lawsuits involve Yaz - the country’s best-selling birth control pill - and Yasmin, which both contain a distinct kind of progestin hormone, called drospirenone. In studies, the two drugs have been associated with a higher risk of blood clot and stroke than other birth control pills. But the difference is small and should not matter for most patients, says Dr. Rebecca Kolp, an obstetrician and gynecologist at Massachusetts General Hospital. She does not recommend those two brands for women over 35 who smoke, or for women who have a family or personal history of strokes.
“There are definitely health benefits to birth control, too,’’ Kolp added, such as a decreased risk of ovarian and endometrial cancer, a decreased risk of anemia, and lighter menstrual periods. Yaz and Yasmin are popular, she said, because they seem to reduce the bloating many women suffer during menstruation.
Research on Yaz and Yasmin suggests that 4 out of 5,000 women taking it would develop blood clots, whereas other pills with both estrogen and progestin have a risk closer to 2 in 5,000.
Carusi compares the difference between taking Yaz or Yasmin and taking other birth control pills to the difference between being given one lottery ticket versus two. “Even with a second lottery ticket, you won’t go out and buy a house,’’ she said. “The odds are still small.’’
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Correction: Because of a reporting error, the Health Answers column in the Nov. 30 "g" section misstated the health risk of estrogen in birth control pills. The estrogen slightly raises the risk of suffering blood clots or a stroke. Pills consisting primarily of another hormone, progestin, pose a lower risk, though some forms of progestin are safer than others.
