7 Dangers of Birth Control Pills and Better Alternatives

7 Dangers of Birth Control Pills and Better Alternatives

Birth control pills are hormonal medications used to prevent unwanted pregnancies. They are also commonly prescribed for painful and heavy periods, hormonal acne, and other symptoms of hormonal imbalances. Unfortunately, hormonal birth control pills are not without side effects and health risks.

They may affect your hormonal balance, gut microbiome balance, brain and mental health, and increase the risk of blood clots, liver dysfunction, nutrient deficiencies, and cancer. Fortunately, there are non-hormonal birth control options, and you can recover your body from the side effects of hormonal birth control pills through natural strategies.

In this article, I will explain what birth control pills are, including the different types of birth control pills. You will understand the common side effects of birth control pills. I will share the 7 potential dangers of birth control pills. I will share the natural birth control alternatives you may consider instead of hormonal birth control pills. I will recommend some steps to take to recover from birth control side effects and health effects naturally.

What are Birth Control Pills

Birth control pills, also known as “the pill” or oral contraceptives, are medications prescribed to prevent unwanted pregnancies. About 25 percent of women between 15 and 44 use birth control pills to prevent pregnancies or for other reasons (1).

Birth control pills need to be taken at the same time, daily. At perfect use, they are 99 percent effective at preventing pregnancies. At typical use, they are 93 percent effective. 

Besides preventing pregnancies, birth control pills may also be prescribed to improve acne, regulate or temporarily stop the menstrual cycle, improve heavy bleeding, improve painful menstrual cramps, reduce symptoms of premenstrual syndrome (PMS), lower endometriosis-related pain, reduce menstrual migraines, reduce symptoms of fibroids or cysts, or decrease the symptoms of other hormonal imbalances. About 14 percent of users take birth control pills for other reasons besides birth control.

Different Types of Birth Control Pills

There are many different brands of birth control pills on the market. However, we can put each of them into one of two categories: combined pills or progestin-only pills (1).

Combined Birth Control Pills

Combined birth control pills contain two different types of female hormones: estrogen and progesterone. More specifically, we are talking about chemicals that mimic estrogen and progesterone. Their purpose is to stop ovulation to prevent pregnancy.

During ovulation, the female body releases an egg each month that can be potentially fertilized by a sperm to achieve pregnancy. When using a combined birth control pill, this egg release doesn’t occur, thus fertilization cannot happen. The combined birth control pill also works on the thickening of cervical mucus and the thinning lining of the uterus to stop fertilization.

Combined pills need to be taken for 21 to 24 days. For the remaining 7 days of the cycle, women take so-called sugar pills that do not include hormonal active ingredients. During the time of the sugar pill, women get their period. When on a combined birth control pill, women still won’t become pregnant when taking these sugar pills.

Some forms of combined birth control pills skip the sugar pills for some months and take the pills with active ingredients for up to 84 days straight. This means they won’t be getting their period for many months.

Some combination birth control pills are low-dose pills with lower hormones. They contain less than 50 micrograms of estrogen, more specifically ethyinyl estradiol. These combination birth control pills are recommended to women who are sensitive to ones with a higher dose.

Progestin-Only Birth Control Pills

Progestin-only birth control pills are also referred to as minipills. They only contain progestin, but not estrogen. They are commonly prescribed to women who experience side effects or interactions with combination birth control pills or are more sensitive.

Progestin-only birth control pills do not stop ovulation. They only thicken the cervical mucus and thin the lining of the uterus. Progestin-only pills are more likely to cause breakthrough bleeding. There are fewer brands available of progestin-only birth control pills than combination birth control pills.

Common Side Effects of Birth Control Pills

The menstrual cycle is naturally characterized by rising and falling estrogen and progesterone levels throughout the month. Birth control pills keep estrogen levels unnaturally high and interfere with this cycle.

They also stop ovulation to prevent pregnancy. This is not natural and not exactly safe for your body. Side effects often come from this increased level of estrogen, though it can be from other reasons.

Potential risks and side effects of birth control pills may include (2):

• Weight gain
• Nausea
• Cramping
• Irregular bleeding or spotting between periods
• Breast tenderness
• Headaches or migraine
• Increased blood pressure
• Liver or gallbladder issues, including benign tumors
• Potentially increased risk of breast cancer
• Potentially increased risk of blood clots, heart attack, and stroke

Though this is not a side effect, it’s important to mention that birth control pills don’t protect you against HIV and other sexually transmitted infections. Women who take birth control pills may be less likely to use another form of protection against sexually transmitted diseases, which may increase their risk of being affected by them.

Birth control pills use synthetic hormones that are also used in hormone replacement medication, including for post-menopause and menopause symptoms. Though many health authorities and doctors still claim that birth control pills are safe and effective, we have increasing research evidence that synthetic hormones may carry some health risks.

They may increase chronic inflammation and hormonal issues. Though they are often prescribed to improve PMS and menstrual symptoms, some women may actually experience more cramps, more painful periods, or increased periods due to excess estrogen and low levels of estrogen.

Since birth control pills affect your hormones and your hormones affect everything, they may affect your immune, endocrine, and neurologic health, energy, memory, concentration, motor coordination, brain health, and more. In the next section, I will go into some specific health risks of birth control pills.

7 Dangers of Birth Control Pills

Birth control pills don’t come without health risks. Here are the top 7 dangers of using birth control pills.

Nutrient Deficiencies

Taking birth control pill is not as simple as just popping a pill. Your body has to metabolize it. To do this, your liver needs to use an extra amount of micronutrients. What does this mean? Taking birth control pills can increase the risk of nutrient deficiencies in these micronutrients without precautions. 

According to a 2013 review published in the European Reviews for Medical and Pharmacological Sciences, the main nutrient deficiencies in concern include B vitamins, such as folate, vitamins B2, B6, B12, vitamins C and E, and the minerals magnesium, selenium and zinc (4).

If this is doubled by a poor diet low in micronutrients, the risk of deficiencies can be even higher. Consuming a nutrient-dense diet and taking supplements may help to reduce the risk of nutrient deficiencies while on birth control pill.

Impacts the Brain and Mental Health 

Estrogen and progesterone imbalance can affect all areas of your body, including your brain’s response system, which may lead to cognitive and psychological concerns. Taking birth control pills can lead to changes in the brain and may increase irritability, anxiety, and depression.

A 2020 systematic review of neuroimaging studies published in Frontiers in Psychology has found that birth control pills may cause structural and functional changes in different areas of your brain, including the amygdala, hippocampus, prefrontal cortex, and cingulate gyrus (5).

A 2016 study published in JAMA Psychiatry has found that over 1 million women taking birth control pill and other hormonal contraceptives had an increased risk of getting their first diagnosis of depression or being prescribed depression medication for the first time compared to women not on the pill (6).

Women taking progestin-only birth control pills, vaginal rings, and the transdermal patch had an even higher risk compared to others. According to a 2023 study published in Epidemiology and Psychiatric Sciences, oral contraceptives may increase the risk of depression by 79 percent in the first two years compared to women who don’t use the pill (7).

Disrupts the Gut Microbiome

Birth control pills may also affect your gut microbiome. They may increase the risk of yeast infections, fungal overgrowth, bad bacterial overgrowth, digestion, bowel motility, and leaky gut syndrome.

According to a 2016 study published in the Iranian Red Crescent Medical Journal, oral birth control pills may increase the risk of candida infections (8). If there is candida colonization in the vagina, it often means there are imbalances in other areas of the body too, including the gut microbiome.

2021 research published in Environmental Microbiology has found that birth control pills may reduce the diversity and change the composition of the gut microbiome (9). A 2016 review published in Drug Safety has found that birth control pills and hormonal therapy for menopause may also increase the risk of inflammatory bowel disease (10).

Increases Risk of Autoimmune Disease  

As I mentioned, taking birth control pills may increase the risk of candida and yeast overgrowth (8). Unfortunately, this can lead to an array of other issues.

Toxins from yeast overgrowth can increase chronic inflammation, and various chronic or inflammatory issues, including migraines, fibromyalgia, digestive disorders, and autoimmune conditions. By impacting the gut and increasing the risk of leaky gut syndrome, it may further increase the risk of inflammatory and autoimmune issues. 

A 2016 review published in Drug Safety has found that birth control pills and hormonal therapy for menopause may also increase the risk of inflammatory bowel disease, including Crohn’s disease and ulcerative colitis, two autoimmune conditions affecting the gut (10). A 2017 review published in Linacre Q has found that using birth control pills may increase the risk of developing a variety of autoimmune diseases, including Crohn’s disease, interstitial cystitis, and lupus (11).

Disrupts Liver Function 

Hormonal birth control pills may also disrupt liver function. A 2022 comprehensive cross-sectional study published in PLoS One has looked at the liver function tests of women taking birth control pill and other hormonal birth control methods (12). They broke up the 264 participants into two groups: birth control users and non-users.

Birth control users used one of any of these hormonal contraceptive options, including the combination birth control pill, Depot medroxyprogesterone acetate (DMPA), Norplant, and Implant users. 

They found a statistically significant higher mean value of liver enzymes in hormonal birth control users. Their aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT) levels were significantly higher than the other, non-birth control user group.

The mean value of total and direct bilirubin (mg/dL) also had a statistically significant elevation, both for total bilirubin and direct bilirubin respectively, but not for protein and albumin. Results indicate that hormonal birth control, including the pill, may pose a risk to liver function and health, and liver levels should be carefully monitored when using hormonal birth control.

Increases Risk of Blood Clots

Birth control pills may also increase the risk of blood clots due to the increase in estrogen. There is a link between high estrogen levels or using estrogen hormone therapy and developing venous thromboembolism, which is blood clots in the vein (13). The higher the estrogen disease, the higher the risk of blood clots. 

A 2018 systematic review published in Linacre Q has found that hormonal birth control may increase the risk of venous thrombosis (14). Deep vein thrombosis, or blood clots in the legs, may also increase the risk of pulmonary embolism if the clots break and move to the longs.

A 2024 study published in Blood has found that using hormonal birth control may increase the risk of blood clots, however, this risk goes away after 2 to 4 weeks of stopping birth control pill usage (15).

May Increase Cancer Risk 

Finally, using birth control pills may also increase your risk of cancer. According to the National Cancer Insitute, using birth control pills may increase the risk of breast cancer in about 1 in 8 individuals (16). Taking birth control pill before giving birth to their first child may also increase the risk of breast cancer by 44 percent.

On the other hand, some research suggests a somewhat lower risk. A 2018 study published in the Practice Advisory has agreed that hormonal birth control pills may increase the risk of breast cancer but found that this risk is small (17). However, whether the risk is small or large, it may not the risk worth taking.

As the Breast Cancer Organization website states, using birth control pills may overstimulate breast cells by the hormones used to stop pregnancy, which may increase the risk of breast cancer, which is the most concerning for those with a family history of breast cancer or having a breast cancer gene (18).

A 2023 study published in PLoS Medicine has found that progesterone-only hormonal birth control has similar risk factors for developing breast cancer as combined birth control pills (19).

Natural Birth Control Alternatives

Fortunately, it is not necessary to use hormonal birth control pills. There are some safe, effective, and more natural birth control alternatives to prevent unwanted pregnancies. Birth control options that don’t require taking hormones and medications include:

• Male condoms: Male condoms are thin covers made from latex, polyurethane, and lambskin worn on the penis during intercourse. They are 98 percent effective at ideal use and 87 percent effective at typical use. Their effectiveness is similar to the effectiveness of hormonal birth control pills.
• Female condoms: Female condoms are thin barrier methods used during intercourse made from latex, polyurethane, and lambskin worn on the penis during intercourse. They are 95 percent effective at ideal use and up to 82 percent effective at typical use.
• Diaphragms: Diaphragms are made of thin, soft rubber mounted on rings that are used as a barrier method. It covers the cervix and stops the sperm when inserted into the upper part of the vagina. Diaphragms have to be fitted by a healthcare provider. They are 92 to 96 percent effective.
• Cervical cap: It is a soft rubber barrier method. It covers the cervix and blocks sperm from entering the uterus to prevent pregnancy. It needs to be fitted by a healthcare provider who can teach you how to use it. It can remain in place for 48 hours. It is 92 to 96 percent effective.
• Natural family planning: Natural family planning, also known as fertility awareness, is a completely natural method. It involves tracking the woman’s menstrual cycle and identifying the time of fertility. It is 91 to 99 percent effective when used correctly.
• Calendar method: This method requires identifying the time of ovulation and abstaining from sex during this time. At perfect use, it can be 98 percent effective but at typical use, it is only 75 percent effective. It is better to combine this method with another option, such as the temperature or mucus method or male or female condoms.
• The temperature method: This strategy helps to identify when a woman ovulates by tracking their basal temperature every morning. When used consistently and correctly, it can be 99 percent effective. However, illness, lack of sleep, stress, and other factors may affect one’s temperature so it may not always be accurately used as a solo method.
• Mucus method: This strategy relies on observing the texture of the vaginal discharge, which can help the woman identify their rising levels of estrogen and identify ovulation or other parts of the cycle. It is not the best method to use by itself, as with typical use it is only effective at 75 percent.

Steps to Take to Heal from Birth Control Side Effects

If you’ve been taking birth control pills, you may want to consider finding another, hormone-free, natural birth control option. In the meantime, you can reduce side effects and increase your health through natural strategies.

Once you stop taking birth control pills or you have already discontinued using them, you can recover your body from the side effects and other health issues caused by birth control pills. Here are the steps I recommend taking to heal from birth control side effects:

Anti-Inflammatory Nutrition Plan

I recommend following an anti-inflammatory nutrition plan. Avoid refined sugar, refined oil, deep-fried food, junk food, artificial ingredients, additives, and overly processed food products. 

Eat lots of greens, vegetables, sprouts, fermented foods, fruits, nuts, seeds, grass-fed meat, pasture-raised eggs, pasture-raised poultry, wild-caught fish and seafood, and wild game. 

Try to eat organic food as much as possible to ensure high nutrient quality and no exposure to pesticides, herbicides, hormones, and toxins. If you can’t eat organic at all times, pay attention to the Dirty Dozen, Clean Fifteen List. Avoid non-organic foods from the Dirty Dozen list but you may eat non-organic produce from the Clean Fifteen list if you must.

Always wash well and peel when applicable. Eating local and fresh-picked from a farm or your garden can also ensure higher nutrient status and quality of your food as early picking, transport, and packaging may reduce nutrient content in your produce. 

Reduce Stress & Optimize Sleep

Reducing stress and optimizing sleep is critical for reducing inflammation, supporting optimal nutrient levels, and allowing your body to rest and repair. I recommend practicing meditation, breathwork, mindfulness, and gratitude to reduce stress and support sleep. You may also try stretching, Tai chi, or Qi gong for reducing and managing stress. 

Avoid electronics, sugar, alcohol, and heavy food in the evening close to bedtime. Ideally, of course, you want to avoid sugar and processed food, reduce or eliminate alcohol, and reduce electronic use during the day too but it is especially critical in the 3 to 4 hours leading up to your sleep. If you must use electronics, use blue-light-blocking glasses and use blue-light-blocking light bulbs in your home. E

Engage in activities that can help you wind down, such as reading, taking a bath, journaling, or calming family time. Support your sleep with a supportive mattress and pillows, comfortable bedding, blackout curtains, and an eye mask. Sleeping in a cool room around 65F may help to support your sleep as well.

Address Key Nutrients 

Taking birth control pills may increase your risk of deficiencies in a long list of micronutrients including B vitamins, such as folate, vitamins B2, B6, B12, vitamins C and E, and the minerals magnesium, selenium, and zinc. To reduce the risk of and improve the loss of these key nutrients, I recommend using a good multivitamin supplement. I recommend Complete Multi-Vitamin. 

Complete multi-vitamin is a full-spectrum multivitamin with Albion-chelated minerals for maximum absorption and bioavailability. It offers the necessary amount of B vitamins, folate, vitamins K1 and K2, vitamin E, vitamin C, quercetin, rutin, and hespederin.

Take 4 capsules per day (2 with each meal) or as directed by your health-care practitioner. This product is recommended for those with adequate intake and absorption of iron but who may benefit from additional copper.

Support Liver Health

Since birth control pills may compromise your liver function, it is critical that you support your liver health. I recommend consuming an anti-inflammatory diet with lots of liver-friendly foods, including organic, pasture-raised animals or wild-caught fish, beef liver, organic pasture-raised eggs, cruciferous vegetables, such as broccoli, Brussels sprouts, cauliflower, and kale, as well as beets, avocados, green tea, grapefruit, lime, and lemon.

Try liver-friendly herbs, such as spirulina, chlorella, milk thistle, ginger, dandelion root, cilantro, garlic and turmeric. Hydrate your body well. Try Epsom salt baths and Castor oil packs. Support your gut. Reduce stress and deal with any anger. Sleep plenty. You may learn more about supporting your liver health by reading this article.

Liver Support

You may also benefit from a supplement for liver health. I recommend using Liver Support. Liver Support is a blend of nutrients which have immune-supportive and antioxidant properties and help support a balanced inflammatory response.

This synergistic blend of hepatoprotective nutrients includes the fungus Cordyceps sinensis and reishi mushroom, both of which have immune-supportive and antioxidant properties and help to support a balanced inflammatory response. It also contains N-acetyl-cysteine (NAC), which helps protect the body from oxidative stress and upregulates the formation of glutathione, the predominant antioxidant found in the liver. 

The mushroom extracts and herbal ingredients in this product are designed to protect liver cells against oxidative damage which may affect the function of the liver.* The ingredients also actively contribute to detoxification processes in the liver by supplying nutrients that may enhance the biochemical reactions involved in neutralizing harmful substances. Take 4 capsules per day or as directed by your healthcare practitioner.

Improve Gut Health 

Since using hormonal birth control pills may disrupt your gut microbiome balance and gut health, it is important that you improve your gut function. I recommend following the 5 R’s to healing gut inflammation and leaky gut syndrome. What are the 5 R’s? Remove, replace, reinnocculate, repair, and rebalance.

Remove

Remove all inflammatory foods, including refined sugar, refined oil, artificial ingredients, additives, food allergens, food sensitivities, junk food, and overly processed foods. Remove any infections. You can get gut health testing done, including the GI Map Stool Analysis, to identify any underlying gut infections or other chronic infections and address them with appropriate herbs, supplements, food, and lifestyle changes. 

Remove any medications, if possible, that may disrupt your gut microbiome. These medications may include related issues include antibiotics, proton pump inhibitors (PPI’s), selective serotonin reuptake inhibitors (SSRIs), non-steroidal anti-inflammatory drugs (NSAIDs), and oral contraceptives. Always work with a doctor when removing or reducing any medication. 

Finally, remove any other gut stressors. This includes exposure to environmental toxins and mold, chronic emotional and physical stress, and poor sleep.

Replace

Follow a gut-healing diet. This means eating lots of nutrient-dense foods, including greens, vegetables, low glycemic index fruits, herbs, spices, and clean animal protein. Some people may benefit from a low-FODMAP, elemental, or semi-elemental diet for a short term. 

Support digestive enzymes, stomach acid levels, and bile flow. To improve your stomach acid levels, I recommend using apple cider vinegar water, adding ginger to your meals or tea, holding off on drinking water until after your meal, eating slowly, chewing your food well, hydrating well outside of mealtimes, and using liquid nutrition, such as protein shakes.

You may try try digestive enzymes, such as Super Dzyme, before meals and betaine hydrochloric acid, such as Acid Pro-Zyme, for improved stomach acid production. You may also try Super Digest HCL with betaine hydrochloride (HCI) for proper stomach acidity and optimal breakdown of food. 

Reinnoculate 

Add prebiotic and probiotic-rich foods to your diet to reseed your gut microbiome.  recommend probiotic-rich, fermented foods, such as sauerkraut, fermented vegetables, coconut kimchi, kefir, and kombucha. Please note that fermented foods are high in histamine and can be triggering if you have histamine intolerance, so avoid them if you do.

To support healthy gut bacteria, you may add more prebiotic-rich foods, such as Jerusalem artichokes, apples, jicama, garlic, onion, and leeks. However, prebiotics-rich foods can be triggering for some people and are not appropriate if you are on a low-FODMAP or carnivore diet.

In addition to prebiotics and probiotics in food, I recommend using a high-quality daily probiotic supplement. I recommend using MegaSportBiotic probiotics.  It contains a unique blend of 5 Bacillus spores designed to protect its human host. Unique from every other probiotic on the market, it is the first broad-spectrum spore-based probiotic clinically shown to recondition the gut and withstand the acidic environment of the gastric system.

Bacillus species found in MegaSporeBiotic are characterized as functional food because of their pigmentation and thus contain antioxidants. Spore-based carotenoids are of greater nutritional value because the spores are not easily degraded by low stomach pH.  MegaSporeBiotic probiotics are clinically found to repair symptoms of gut imbalances within 30 days. It also offers immune support. Use it daily with food.

Repair

Use key nutrients to repair your gut microbiome and gut lining. I recommend using L-glutamine, aloe vera, and licorice root. L-glutamine is a non-essential amino acid that serves as an energy source for both your intestinal and immune cells.

It helps to keep your intestinal barrier healthy and ensure the healthy growth and function of your intestinal cells. Aloe vera is a cactus-like plant with a compound that helps to reduce inflammation and supports the gut lining. Licorice root contains glycyrrhizin, which is an active compound with antioxidant, antimicrobial, and anti-inflammatory properties.

You may try Gut Repair as a great supplement to repair your gut lining. features four specialized ingredients for enhanced gastrointestinal support. This unique formula contains a concentrated extract of licorice that has been processed to remove glycyrrhizin, thus reducing risk of side effects associated with licorice. It also contains l-glutamine, aloe vera extract, and arabinogalactan for full gut support.

Rebalance

Finally, it’s time to rebalance your gut microbiome and your body. Reduce your stress levels and learn to manage stress better. Meditation, breathwork, mindfulness, gratitude, and journaling are great tools for this. Improve your sleep. Get 7 to 9 hours of restorative sleep each night.

Move your body and exercise regularly. I recommend getting some movement in throughout each day, including stretching, short walks, impromptu dancing sessions, relaxing yoga, or playtime with your kids and pets. I recommend exercising at least 5 days a week for 20 to 30 minutes each session. Combine cardiovascular workouts with strength and resistance training.

Get plenty of sunshine and fresh air to improve your vitamin D levels and uplift your mood. You may combine this with some outdoor exercise and movement. Follow a nutrient-dense, anti-inflammatory diet as outlined earlier in this article.

Final Thoughts

Birth control pills are hormonal medications used to prevent unwanted pregnancies, as well as, for painful and heavy periods, hormonal acne, and other symptoms of hormonal imbalances. Hormonal birth control pills are not without side effects and health risks.

There are non-hormonal birth control options, and you can recover your body from the side effects of hormonal birth control pills through natural strategies. If you are or have been taking birth control pills, I recommend considering the information in this article carefully and following my steps to take to recover from birth control side effects and health effects naturally.

If you want to work with a functional health coach, I recommend this article with tips on how to find a great coach. Our website offers long-distance functional health coaching programs with our world-class team of health coaches. For further support with your health and other goals, just reach out—our fantastic coaches are here to support your journey.

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Sources in This Article Include:

1. Cooper DB, Patel P. Oral Contraceptive Pills. [Updated 2024 Feb 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Link Here

2. Birth control. FDA. Link Here

4. Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1804-13. PMID: 23852908

5. Brønnick MK, Økland I, Graugaard C, Brønnick KK. The Effects of Hormonal Contraceptives on the Brain: A Systematic Review of Neuroimaging Studies. Front Psychol. 2020 Oct 27;11:556577. doi: 10.3389/fpsyg.2020.556577. PMID: 33224053

6. Skovlund CW, Mørch LS, Kessing LV, Lidegaard Ø. Association of Hormonal Contraception With Depression. JAMA Psychiatry. 2016 Link Here

7. Johansson T, Vinther Larsen S, Bui M, Ek WE, Karlsson T, Johansson Å. Population-based cohort study of oral contraceptive use and risk of depression. Epidemiology and Psychiatric Sciences. 2023 Link Here

8. Aminzadeh A, Sabeti Sanat A, Nik Akhtar S. Frequency of Candidiasis and Colonization of Candida albicans in Relation to Oral Contraceptive Pills. Iran Red Crescent Med J. 2016 Aug 17;18(10):e38909. doi: 10.5812/ircmj.38909. PMID: 28184328

9. Mihajlovic J, Leutner M, Hausmann B, Kohl G, Schwarz J, Röver H, Stimakovits N, Wolf P, Maruszczak K, Bastian M, Kautzky-Willer A, Berry D. Combined hormonal contraceptives are associated with minor changes in composition and diversity in gut microbiota of healthy women. Environ Microbiol. 2021 Jun;23(6):3037-3047. doi: 10.1111/1462-2920.15517. Epub 2021 May 6. PMID: 33876556

10. Khalili H. Risk of Inflammatory Bowel Disease with Oral Contraceptives and Menopausal Hormone Therapy: Current Evidence and Future Directions. Drug Saf. 2016 Mar;39(3):193-7. doi: 10.1007/s40264-015-0372-y. PMID: 26658991

11. Williams WV. Hormonal contraception and the development of autoimmunity: A review of the literature. Linacre Q. 2017 Aug;84(3):275-295. doi: 10.1080/00243639.2017.1360065. Epub 2017 Aug 18. PMID: 28912620

12. Chane E, Wondifraw H, Hadgu R, Fasil A. Assessment of liver function tests of women taking hormonal contraceptives at University of Gondar comprehensive specialized hospital and Family Guidance Association of Gondar (FGAE), 2022; a comparative cross-sectional study. PLoS One. 2023 Aug 17;18(8):e0289746. doi: 10.1371/journal.pone.0289746. PMID: 37590278

13. Horvath S, Schreiber CA, Sonalkar S. Contraception. [Updated 2018 Jan 17]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Link here

14.  Keenan L, Kerr T, Duane M, Van Gundy K. Systematic Review of Hormonal Contraception and Risk of Venous Thrombosis. Linacre Q. 2018 Nov;85(4):470-477. doi: 10.1177/0024363918816683. Epub 2019 Jan 3. PMID: 32431379

15. Longitudinal profile of estrogen-related thrombotic biomarkers after cessation of combined hormonal contraceptives 2024. Blood Link Here

16. Breast cancer NIH Link Here

17. Hormonal Contraception and Risk of Breast Cancer 2018 Link Here

18. Breast Cancer Organization. Link Here

19. Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis 2023 Link here