Should long-term use of birth control pills be intermittent?

The safety of contraceptive use has three main aspects, including cardiovascular disease, carcinogenesis and reproductive safety. Currently, the safety risk associated with pill use for which there is some clinical evidence and expert consensus is venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, and the increased risk of thrombosis occurs within 3 to 6 months of taking the pill and does not continue to increase with duration of use. Contrary to fears, the following evidence also suggests benefits from long-term use of the pill. The risk of thrombosis is elevated in women taking the pill at 9 per 10,000 woman-years, which is one times higher than in non-pregnant women who are not taking the pill, but is much lower than the risk of thrombosis during pregnancy and puerperium (30 per 10,000 woman-years and 65 per 10,000 woman-years, respectively). Moreover, mortality due to VTE was much lower than mortality due to abortion. In addition, in 2007, Dinger et al. found that a very low risk of thrombosis was more likely to occur during the initial period of use of the pill, especially during the first 3 months, and that the risk of VTE increased again when the pill was reintroduced after a period of discontinuation. The risk of thrombosis also includes factors such as smoking, history of diabetes, obesity, and hypertension, and women with these risk factors should avoid using COCs. Long-term use of birth control pills has been found to be beneficial for women’s bone mineral density. 2011, Wei et al. reported on a cross-sectional study in which a randomized group of people aged 50-80 years was selected for the study, and a total of 491 women completed questionnaires and bone mineral density tests. A total of 491 women completed questionnaires and bone mineral density tests, 460 of whom were also analyzed for spinal deformity. The results showed that, after adjusting for confounding factors, the whole-body and spinal bone mineral density of women who had taken COCs was significantly higher than that of women who had not used contraceptives, and the longer the period of time spent on contraceptives, the more pronounced was the protection against the reduction in whole-body and spinal bone mineral density. The risk of spinal deformation was significantly reduced after 5 to 10 years of pill use. In conclusion, the results of the study on the safety of long-term use of contraceptives show that the pill is safe, and long-term use of the pill can bring more benefits, and in the discontinuation of intermittent use of the pill will only increase the risk of unwanted pregnancy, so it is best not to interrupt the use of the pill, and it is recommended to take it for a long period of time.