Hormonal Contraception - Risks

Hormonal contraception is certainly the most widespread form of family planning. Its essence is regular administration of a combination of female sex hormones (estrogen and progesterone) to prevent pregnancy.

Side effects and other risks

Increased blood clotting

Female sex hormones present in the hormonal contraception increase blood clotting and the risk of thrombosis occurrence, especially the deep vein thrombosis of the lower extremities and pulmonary embolism. The risk itself is not so high, but it may be increased by other factors (genetic mutations such as Factor V Leiden, smoking, etc.). Therefore, hormonal contraception should not be prescribed to female smokers and women with occurrence of thrombosis in their close relatives should be examined for presence of most common congenital cases with increased blood clotting. Hormonal contraception should be either discontinued before extensive planned surgical interventions, or the woman should be protected by a preventive dose of a LMWH during hospitalization.

Weight gain

The female sex hormones can cause increased weight gain, usually a few pounds. However, when the woman has a healthy lifestyle with plenty of physical exercise, the weight gain is not significant.

Higher risk of cardiovascular diseases

Contraception can raise blood pressure and cause high cholesterol. These factors can have a negative effect on higher frequency of cardiovascular diseases.

Mental changes

Hormonal contraceptives may cause mood swings, depression and sometimes reduced appetite for sex. Given how much the psyche of women is associated with sex hormones, this is not surprising. 

Nonspecific unpleasant symptoms

These include headache, nausea, fatigue, hot flashes, feelings of internal tension and chest pain. If these problems are too troublesome, the used preparation should be changed for another, or the hormonal contraception should be discontinued.

Reactions with other drugs

Hormonal contraceptives can react with many drugs and vice versa. Certain substances can significantly decrease the effect of hormonal contraception and cause unwanted pregnancy. The reduced effects of contraceptives have been reported by usage of some antibiotics and antiepileptics. Especially dangerous from this point of view is herb known as St. John's wort with its products (herbal teas).

Benign liver tumors

Long-term use of contraceptives can cause increased occurrence benign liver tumors. This has been also reported in chronic usage of anabolic steroids by bodybuilders. 

Risk of cancer issue

Finally some good news – chronic usage of hormonal contraceptives probably slightly increases the risk of breast cancer, but on the other hand, it sharply reduces the risk of uterine cancer and ovarian cancer. There is a slightly higher incidence of cervical cancer in women using the hormonal contraception, but this is rather caused by a statistically higher promiscuity of women protected by hormonal contraception. Higher promiscuity and unprotected sex equals higher risk of HPV infection, which is the main causative factor of cervical cancer.

Higher promiscuity and irresponsible behavior

Some women tend to behave less responsibly (promiscuity and unprotected sex), because they feel to be protected by the contraception. This is true in sense of an unwanted pregnancy, but otherwise contraceptives have no protective effect from sexually transmitted diseases (gonorrhea, syphilis, AIDS, etc.).


Hormonal contraception is one of the most revolutionary drugs of modern times, which completely changed the society of developed countries (in both negative and positive ways). Expansion of hormonal contraception has a huge impact on the reduction of cases of unwanted pregnancies and it reduces the number of abortions. In addition, hormonal contraception has certain positive effects on women's health. On the other hand, we all should know about possible risks and try to keep them as low as possible.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources