The combined oral contraceptive pill -- recent developments, risks and benefits

Best Pract Res Clin Obstet Gynaecol. 2014 Aug;28(6):825-34. doi: 10.1016/j.bpobgyn.2014.06.003. Epub 2014 Jun 27.


The introduction of the birth control pill as an effective, coitally-independent method of contraception was a public health milestone of the last century. Over time, combined oral contraception (COC) formulations and pill-taking regimens have evolved with improved safety and tolerability while maintaining contraceptive efficacy. In addition to protection against pregnancy, use of combined oral contraception confers a number of significant non-contraceptive benefits to users. COC use is also associated with well-studied risks. Common side effects are generally self-limiting and improve with increasing duration of use while serious adverse events, including venous thromboembolism, are rare among healthy COC users. Contraceptive decision-making should include consideration of both the risks and benefits of a given method versus the real consequences of unintended pregnancy.

Keywords: gynaecology; hormonal contraception; non-contraceptive benefits; oral contraception.

MeSH terms

  • Bone Density / drug effects
  • Colorectal Neoplasms / prevention & control
  • Contraception* / methods
  • Contraception* / trends
  • Contraceptives, Oral / administration & dosage*
  • Contraceptives, Oral / adverse effects*
  • Contraceptives, Oral, Combined / administration & dosage
  • Contraceptives, Oral, Combined / adverse effects
  • Contraceptives, Oral, Hormonal / administration & dosage
  • Contraceptives, Oral, Hormonal / adverse effects
  • Dysmenorrhea / drug therapy
  • Endometrial Neoplasms / prevention & control
  • Evidence-Based Medicine
  • Female
  • Gynecology / trends
  • Humans
  • Menstrual Cycle / drug effects
  • Ovarian Neoplasms / prevention & control
  • Pregnancy
  • Risk Assessment
  • Risk Factors
  • Venous Thromboembolism / chemically induced
  • Venous Thromboembolism / prevention & control


  • Contraceptives, Oral
  • Contraceptives, Oral, Combined
  • Contraceptives, Oral, Hormonal