Is Being on Birth Control Long Term Bad for You? A Comprehensive Look

October 9, 2025 •

4 min read

In the United States, about 65% of women aged 15–49 are current contraception users [1.7.1]. A common question that arises is, is being on birth control long term bad for you? For most healthy people, long-term use is considered safe, but it involves a balance of benefits and risks [1.4.3].

Quick Summary

For most healthy individuals, long-term birth control is safe and effective. It offers significant non-contraceptive benefits but also carries risks, including a mixed cancer profile and a small increase in blood clot risk.

Key Points

Benefit vs. Risk: For most healthy individuals, the benefits of long-term birth control use generally outweigh the potential risks [1.4.3].
Reduced Cancer Risks: Long-term use significantly lowers the risk of ovarian and endometrial cancers, an effect that can last for decades after stopping [1.2.5].
Slightly Increased Risks: There is a small, temporary increase in the risk of breast and cervical cancer, and a small risk of blood clots, especially with estrogen-containing methods [1.2.5, 1.4.4].
Non-Contraceptive Advantages: Many use birth control to manage painful or heavy periods, endometriosis, PCOS, and hormonal acne [1.3.3, 1.5.1].
LARCs Are Highly Effective: Long-Acting Reversible Contraceptives (LARCs) like IUDs and implants are the most effective reversible methods due to low user error [1.8.1].
No Impact on Fertility: Using birth control, even for many years, does not negatively affect long-term fertility. It returns to normal soon after stopping most methods [1.2.7].
Consult a Doctor: The best method is highly individual; personal health, family history, and lifestyle are key factors to discuss with a healthcare provider [1.2.2].

Understanding Modern Contraception

Hormonal contraceptives work by releasing synthetic hormones, primarily progestin and sometimes estrogen, to prevent pregnancy [1.8.4]. These hormones can stop ovulation, thicken cervical mucus to block sperm, and thin the uterine lining to prevent implantation [1.8.1]. Methods range from daily pills and weekly patches to long-acting reversible contraceptives (LARCs) like intrauterine devices (IUDs) and arm implants, which can last for several years [1.8.1]. While highly effective for preventing pregnancy, their systemic effects are the basis for both their benefits and risks over long-term use [1.2.1, 1.3.3].

The Extensive Non-Contraceptive Benefits of Long-Term Use

Many people use hormonal contraceptives for reasons beyond pregnancy prevention [1.7.2]. Long-term use is associated with significant health benefits:

Reduced Cancer Risk: One of the most significant benefits is a reduced risk of certain cancers. Use of oral contraceptives can lower the risk of ovarian and endometrial cancer by 30-50% [1.2.5, 1.3.5]. This protective effect can increase with the duration of use and persist for up to 30 years after stopping the pill [1.2.5]. Some studies also show a 15-20% lower risk of colorectal cancer [1.2.5].
Menstrual Regulation and Symptom Relief: Hormonal birth control can make periods lighter, shorter, more predictable, and less painful [1.5.1]. This can also reduce the risk of anemia related to heavy bleeding [1.3.5].
Management of Medical Conditions: It is an effective treatment for managing symptoms of conditions like polycystic ovary syndrome (PCOS), endometriosis, and uterine fibroids [1.3.3, 1.5.1]. It can also improve hormonal acne and reduce unwanted hair growth (hirsutism) by lowering androgen levels [1.5.1].
Other Health Improvements: Birth control can help prevent ovarian cysts, reduce the frequency of menstrual migraines, and manage symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) [1.3.5, 1.5.1].

Potential Risks and Side Effects of Long-Term Use

While generally safe for most healthy individuals, long-term use of hormonal contraception is not without risks. These risks are often influenced by a person's age, lifestyle (like smoking), and personal or family medical history [1.2.2].

Cardiovascular and Clotting Risks

Combination hormonal contraceptives (those with estrogen) are known to increase the risk of blood clots, including deep vein thrombosis (DVT) and pulmonary embolism [1.4.4, 1.4.5]. While the absolute risk is small for most young, healthy users, it is higher for those who smoke, are over 35, or have other risk factors like a family history of clots or migraines with aura [1.2.2, 1.4.5]. The risk is highest in the first few months of use and decreases quickly, within two to four weeks, after stopping the contraceptive [1.4.4, 1.2.7].

A Complex Relationship with Cancer

While birth control lowers the risk for some cancers, it is associated with a slight increase in the risk for others:

Breast Cancer: Studies show a small, temporary increase in breast cancer risk for current or recent users of hormonal contraceptives [1.2.5, 1.4.2]. This risk appears to decline after stopping and is gone by 10 years post-use [1.2.5, 1.4.2].
Cervical Cancer: Long-term use (5+ years) is linked to a higher risk of cervical cancer, which also declines after discontinuation [1.2.5, 1.4.2]. This may be due to hormonal changes making cervical cells more susceptible to HPV, the primary cause of cervical cancer [1.2.5].

Other Considerations

Some users report mood changes, anxiety, or depression, though research on a direct causal link is mixed [1.2.3, 1.2.4]. Hormonal contraceptives can also be associated with nutritional deficiencies, particularly in B vitamins [1.2.2]. When coming off birth control after many years, it can take a few months for the menstrual cycle to return to its natural baseline, and any pre-existing issues like irregular periods or acne may reappear [1.6.2, 1.6.6].

Comparison of Long-Term Contraceptive Methods

The safest and most effective long-term methods are often considered to be Long-Acting Reversible Contraceptives (LARCs) because they have high efficacy and remove the potential for user error [1.8.2].


Method	How It Works	Long-Term Considerations (Pros & Cons)
Hormonal IUD (e.g., Mirena, Kyleena)	Releases progestin to thicken cervical mucus and thin the uterine lining. Lasts 3-8 years [1.8.3].	Pros: Extremely effective (>99%), can reduce period pain and bleeding. Cons: Requires a provider for insertion/removal; may cause irregular bleeding initially [1.8.4].
Copper IUD (Paragard)	Hormone-free; copper creates an inflammatory reaction toxic to sperm. Lasts up to 10 years [1.8.3].	Pros: Highly effective, no hormones. Cons: Can make periods heavier and more painful, especially at first [1.8.4].
Contraceptive Implant (Nexplanon)	A small rod inserted in the arm that releases progestin. Lasts up to 5 years [1.8.2].	Pros: Extremely effective, 'set it and forget it'. Cons: Can cause irregular bleeding, requires a provider for insertion/removal [1.8.1].
Combination Pill	Taken daily, contains estrogen and progestin to stop ovulation.	Pros: Provides non-contraceptive benefits like acne control and lighter periods. Cons: User-dependent (must take daily); higher risk of blood clots than progestin-only methods [1.8.4].

Find more information on contraceptive options at Planned Parenthood

Conclusion: A Personalized Decision

The answer to whether being on birth control long-term is bad for you is nuanced. For the majority of healthy people, the benefits—both contraceptive and non-contraceptive—often outweigh the risks [1.4.3]. The increased risk of blood clots and certain cancers is real but small for most users, while the protective effect against other, more common cancers is substantial [1.2.5, 1.4.2]. The safest choice depends on individual health factors, family history, and lifestyle. Regular consultation with a healthcare provider is essential to assess these factors and ensure the chosen method remains the best and safest option over time [1.2.2].

Frequently Asked Questions

For most healthy people, it is safe to use hormonal birth control for many years, as long as it's approved by a healthcare provider. There is generally no prescribed limit on the duration of use [1.2.2, 1.4.3].

No, long-term birth control use does not cause infertility. Fertility typically returns to your baseline level within a few months after stopping most methods. Any delay may be related to age-related fertility decline that occurred while on birth control [1.2.2, 1.2.7].

There is no medical evidence to support the need for taking a 'break' from hormonal birth control. It is safe for continuous long-term use for most individuals without periodic interruption [1.2.2].

Long-Acting Reversible Contraceptives (LARCs), such as hormonal and copper IUDs and the arm implant, are considered among the safest and most effective long-term options. They have a very high effectiveness rate (>99%) and minimal room for user error [1.8.1, 1.8.2].

Most studies show that birth control pills do not cause significant weight gain. Some people may experience initial fluid retention, which can feel like weight gain but is usually temporary. The birth control shot (Depo-Provera) is the one method linked to potential weight gain in some users [1.2.6, 1.2.7].

The relationship between hormonal birth control and mood is complex and varies by individual. Some users report mood changes, anxiety, or depression, while others find it helps stabilize mood by regulating hormones, especially for those with PMS or PMDD. More research is needed in this area [1.2.3, 1.2.7].

When you stop, your body begins to return to its natural hormonal cycle. This means your fertility returns quickly, and any symptoms you had before starting (like heavy periods, acne, or irregular cycles) may come back. It can take a few months for your cycle to become regular again [1.6.2, 1.6.6].