I barely started on birth control pills for the first time, and I also smoke cigarettes. What can happen?

Answer 1

Great Question. A lot of women are nervous about this combination of smoking and the pill. There are some risks associated; as we all know the scientific evidece of smokings afect upon womens health and assocciated diseases. There are added conditions that you may develop by continuing to smoke whilst on the Birth control pill.

There is some evidence that smoking can decrease the effectiveness of OCs. Smoking causes a breakdown of estrogen, thus lowering the body's estrogen levels, which in turn plays a role in the effectiveness of the pill. Some smokers will experience spotting or breakthrough bleeding on the pill, more so than non-smokers. This could signal that the efficacy of the pill is lowered. More research needs to be conducted to better understand how, to what degree, and in what timetable smoking decreases the pill's effectiveness.

What we know for sure is that women who smoke and take oral contraceptives (OCs) increase their risk of heart disease. This risk is a dose-related situation — meaning, the more you smoke, the older you are, and the higher the levels of estrogen in your pill, the greater the risk. So in regards to heart disease, you need to consider the number of cigarettes you smoke per day, your age, and the type of pill you are taking.

In the meantime, talk with your gynecologist or another women's health care provider about your social smoking. Since you are taking OCs, it's important that s/he know that you smoke in order to consider which birth control pill or another contraceptive is the best option for you.

Also credit ASH, and include ASH's web address: http://ash.org

Combination of Smoking and Birth Control Pills Leads to Heart Problems [07/25-4]
Excerpts from: A Matter of the Heart


Adriana Camacho-Church drkoop.com [07/23/01]

Read the study in the Archives of Internal Medicine Low-Dose Oral Contraceptive Use and the Risk of Myocardial Infarction


A recent study confirmed that women increase the risk of having a first-time
heart attack by 30 times when they smoke 25 cigarettes or more a day and
take a daily, low-dose birth control pill.

Lynn Rosenberg, an epidemiologist at Boston University School of Medicine
in Brookline, Mass., and her colleagues, conducted the research to find out
whether the newer, low-dose birth control pills that contain less than 50
micrograms of estrogen per dose (like those Logan took), are safer than the
oral contraceptives of the past.

Based on her findings, Rosenberg says that in terms of causing
cardiovascular disease, today's low-dose contraceptives "do very little, except
in a heavy smoker."

Light smokers and non-smokers do not seem to be putting themselves at
greater risk of developing heart problems by taking low-dose oral
contraceptives, Rosenberg states in her report.

Published in the April 23rd issue of the Archives of Internal Medicine, the
14-year study was conducted in 75 hospitals in the greater-Boston and
Philadelphia area between January of 1985 and March 1999.

Low-dose oral contraceptives were developed after reports suggested that the
amount of estrogen in older birth control pills had serious side effects,
including strokes, heart attacks and blood clots.

"High-dose birth control pills did have risks even in the absence of smoking,"
says Rosenberg.

Concerned about all the negative press surrounding oral contraceptives and
smoking cigarettes, Logan stopped taking the pill 18 years ago and cut back
from smoking two packs a day to smoking one pack a day.

"I'd rather smoke than take the pill," she says. "It's so hard to quit
(smoking)."

According to data collected between 1965 through 1998 by the American
Lung Association, 22.4 million women in the United States smoke. And
about 10 million-take birth control pills annually, reports the National Center
for Health Statistics.

Rita Redberg, a cardiologist at the University of San Francisco, agrees with
Rosenberg's findings that today's low-dose birth control pills do little harm to
the heart. The study's findings show there is no reason why women should
not take oral contraceptives, says Redberg. The risk of having a heart attack
from low-dose birth control pills is very low, if any, especially if the woman is
under 35 years of age, doesn't smoke heavily, and doesn't have high blood
pressure or diabetes.

Experts agree that blood clots and heart attacks rise steadily after age 35, so
a woman who smokes heavily and is still using oral contraceptives at this
time in her life is greatly increasing her chances of developing a heart attack.

Mary Molan, 50, stopped taking birth control pills at the age of 33 -- 10 years
after she started. "My doctor told me she wasn't going to prescribe anymore
pills because I was a smoker& she said, take something else."

Molan, also a resident of Wilmington, Del., began smoking cigarettes at the
age of 17. By the time she was 23, she was smoking a pack a day and
taking oral contraceptives. In 1997 she stopped smoking cold turkey.

Referring to her study, Rosenberg says, "A woman in her 20s who is a heavy
smoker may not care if her risk of having a heart attack goes up 30 times
because it's so low. But when that woman is 35 and older, her risk increases
because as you age your chances of a heart attack go up. So, it's a different
risk at a different age."

The majority of the women in the study used low-dose combined birth control
pills. Combined pills are made of two synthetic hormones, an estrogen and a
progestogen. In this study, the combined pills contained 30 or 35 micrograms
of estrogen.

Data gathered for the study came from interviews with 627 women who had a
first time nonfatal heart attack and about 3,000 other women hospitalized for
other reasons. All of them were younger than 45.

Patients interviewed were asked questions about the type of oral
contraceptive they used, smoking habits, menopausal status, cholesterol
levels and family history of heart attacks.

At the end of their report, Rosenberg and her colleagues state that the
current warning inside birth control pill packages, urging users not to smoke
while taking the pill, is still appropriate.


From my own knowledge there is a higher incidence of blood clotting and deep vein thrombosis that may occur. This may be an issue if you travel by air frequently.

I believe that the statistics are between 1-3% but cannot find a diffinitive study.

So I guess there is a greater risk of heart trouble and probable stroke aswell due to clotting of blood and high blood pressure.

No smoking is best but perhaps another contraceptive method may suit you.

Answer 2

No, you should stop smoking if you are taking bbirth control pills. irth control pills increase your chance of stroke. Smoking causes your veins to lose elasticity, causes more plaque to build up in the veins and arteries, which can lead to stroke. If you ar on birth control, you already increase your risk. Either a small piece of the plaque can come loose and get stuck somewhere else in your circulatory system, causing clot, or the buildup could restrict the blood flow causing a blood clot. If that blood clot is in your brain, it is a stroke, and cause serious, permanent brain damage. It is dangerous to have two increased risk factors.

Answer 3

Smoking raises your blood pressure, birth control also raises your blood pressure. In concert they can be dangerous, especially if you have ANY other risk factors, even for young healthy women...

Not a good combination for some people certainly...

You should be careful and make sure your doctor KNOWS you smoke cigarettes.

Answer 4

Don't smoke and take birth control pills. Quit one or the other. I recommend quitting the smoking.

Answer 5

You should not take birth control pills if you smoke! It increases the chance of blood clots and heart attacks (yes, even if you're young)!

Answer 6

Your birth control pills came with information that perhaps you should read.

Answer 7

The combination will increase your risk of cancer.

I have never been a big fan of mucking about with hormones.

Answer 8

Probably nothing at this point because you are, I assume very young. But you should not do both for very long.

Answer 9

blood clots
lung cancer
heart attack
emphysema
bad breath
rotten teeth
...and that's just the cigarettes!

Answer 10

you are at a much higher than normal risk for heart attacks, high blood pressure, and stroke.