Just the FAQs: Are There Fertility Risks with Birth Control Pills?

​Hello. I'm Dr. Gil Wilshire of Missouri Fertility here in Columbia, Missouri.  Today, we are going to be talking about birth control pills and fertility.  I get so many questions about birth control pills. Women, their husbands, boyfriends, everyone is worried. "I took birth control pills for a year or five years or ten years, and did I damage my fertility? Did I hurt myself?".  It's a very common question, even though there is no basis in reality, so let's talk about this situation. Women are born with a certain number of eggs. Every day in reproductive years, these little, what I call "baby eggs" or primordial follicles, they wake up, smell the coffee, and if the situation isn't perfect, they die.  So—eggs are waking up and dying every day—no matter what. Whether you are on birth control pills or not, whether you are pregnant or not, or being treated for other conditions, eggs are waking up and dying every days. Birth control pills have nothing to do with this process and do not damage your pool or reserve of eggs.  Birth control pills have multiple medical benefits.  Obviously, they greatly prevent pregnancy; they're not perfect, but they are awfully good. Pregnancies end in miscarriage, sometimes pregnancies are ectopic [located outside of the uterus], and sometimes pregnancies are undesired—all of these pregnancies or a vast majority of these pregnancies are prevented by birth control pills, obviously, so these have beneficial effects on the reproductive system. Birth control pills also have a number of long-term health benefits.  Birth control pills lower the risk of uterine cancer and they lower the risk of ovarian cancer. They are probably neutral when it comes to breast cancer and other conditions, and if a woman is normal weight and does not smoke, they should not affect her risk of heart disease either. The long-term safety of birth control pills is very well established.  Another common question is, "I've been on the pill for a few years, do I need to be off the pill for a while—three months, six months, a year? Do I need to be off the pills for an extended amount of time before we attempt pregnancy?"  The answer to this is a distinct, definite, "No!"  We use birth control pills before fertility treatment cycles all the time to keep ovarian cysts from growing, and they may suppress endometriosis. We can use birth control pills right up until we start fertility treatments. So, you need to realize—in two or three days after the last birth control pill is taken, these hormones are generally excreted by the urinary system—they are gone—and the normal hormone systems all come back to life, so you do not have to take a long time off birth control pills; two or three days is all that is required.  Do not be wasting time "letting it get out of your system" because there is no point in doing that! 
 
So, in summary, birth control pills are very, very safe.  They are the most studied medication in history, in fact, and some would advocate they are safe enough to be sold over-the-counter, so please do not fear health problems from birth control pills. They are very effective, they help the skin, they help cycle control, and I could go on and on about the multiple benefits of these pills. So, if you are not ready to have kids or if you have medical problems, pain, heavy periods, endometriosis, all these things--take your birth control pills without fear of it affecting your future fertility. I hope this is helpful to you. This is Dr. Gil Wilshire of Missouri Fertility in Columbia, Missouri.