Dear Straight Dope:
Does prolonged use of the pill affect a woman's ability to get pregnant? I was told a long time ago that it does, but I've been wondering ever since.
SDStaff Jillgat replies:
Of course it affects a woman’s ability to get pregnant. That’s why they sell it, silly.
Maybe what you meant was whether prolonged use of the pill makes you infertile after you stop using it. It’s a myth that oral contraceptive use causes long-term infertility. There is no difference in pregnancy rates between women a few months after going off the pill and women a few months after discontinuing other temporary birth control methods. Some women after stopping the pill experience irregular menstrual cycles. Many of these women had irregular periods before the pill and might have continued doing so except that the issue was masked by the fact that oral contraceptives artificially regulate the cycle. Women taking the pill have a perfect 28 day cycle.
Since pill users are protected against pregnancy, some may be more likely to be having sex without using a barrier method like condoms. These women are not protected against sexually transmitted diseases that can damage the fallopian tubes, which can lead to an inability to become pregnant. They may blame the pill for this problem even though the pill was only indirectly responsible.
Eighty percent of women going off the pill have normal reproductive cycles within three months and more than 95% are ovulating within a year. There don’t seem to be any health reasons for waiting a period of time after going off the pill before attempting to get pregnant. Most doctors and midwives recommend that women who wish to become pregnant use a barrier method (condoms and/or diaphragm) for three months or so after going off the pill. This allows the ovulatory cycle time to normalize and helps the doctor accurately date the start of the pregnancy.
Oral contraceptives are an extremely reliable birth control method, but occasionally a woman will get pregnant while taking them. Sometimes this happens because she’s missed pills or there’s been a drug interaction. It’s obviously not a good idea for a pregnant woman to be taking hormones such as those found in the pill, so it’s advisable to stop immediately. But there seems to be little or no evidence that there is an increased risk of birth defects to the developing fetus from this temporary exposure.
The pill works primarily by suppressing ovulation — the release of an egg from the ovary midway through the cycle. Today’s pills have much lower doses of hormones than the first oral contraceptives did. Not everyone can take the pill, but it is an effective, safe method of birth control for most healthy, non-smoking women. It is only rarely associated with health problems and is actually protective against some. Pregnancy and childbirth are in fact riskier to most women’s health than use of the pill is.
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