Birth control that contains two hormones, those made by a woman's ovaries like estrogen and progesterone are hormonal contraceptives. They work to prevent pregnancy primarily by suppressing ovulation. The hormones also make cervical mucus less permeable to sperm and make the uterine lining not fitting for the implantation of a fertilized egg. The pill, patch and ring are all about 99% effectual in preventing pregnancy, if used as directed. All of the risks increase with age, but compare it with the chance of death when driving a car is 16 in 100,000 per year.

Risks associated:

Serious problems do not happen very often. However, it is vital to be aware of the four major risks associated with hormonal contraception,

1. Growth of blood clots. They are rare but may arise in large blood vessels in various parts of the body, causing potentially severe effects and even death. Woman on hormones who undergo main surgery requiring immobilization seem to have a greater risk of developing blood clots. Talk to the doctor about stopping hormones before a scheduled major operation

2. Heart attacks and strokes, diabetes, high cholesterol, high blood pressure and especially smoking increase these possibilities. Any woman who smokes must seriously consider quitting. Women over 35 who smoke 15 or more cigarettes a day must not take hormones. Let the health care provider know about the diabetes, high cholesterol or high blood pressure prior to starting hormones. Very rarely, a major increase in blood pressure can develop in woman on hormones. Be sure to have the blood pressure checked after about three months of starting hormones, then yearly after that.

3. Gall bladder disease, though hormonal contraception does not seem to affect the overall risk of developing gall bladder disease. But it may bring on gall bladder problems at a younger age for women who are already susceptible to the disease.

4. Hormone users have an increased risk of developing an extremely rare benign liver tumor called a hepatocellular adenoma. Jaundice should be reported to the health care provider.

Early warning signs of serious problems:

Serious problems connected with hormones are rare and generally have warning signs. It is necessary to notify the health care provider as soon as possible after experiencing any of the following signs of a blood clot like

1. Harsh abdominal pain

2. Stern chest pain or shortness of breath

3. Severe headaches

4. Eye problems like blurred vision, blind spots, flashing lights and

5. Severe and persistent leg pain in the calf or thigh.

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