Recently, I met a patient in the clinic, female, 35 years old, white-collar work, every year unit physical examination, liver function transaminases are slightly higher, ALT50-70U/L or so, physical examination doctors think it may be fatigue, not rested and other reasons, did not care. There are many causes of elevated ALT, many of which are transient and may be related to the above-mentioned causes, while persistent elevation is often pathological. Therefore, I routinely check ultrasound, viral hepatitis, autoimmune hepatitis, and other tests are ruled out. Liver pathology was recommended. The pathological picture did not seem to reveal severe necrotic, fibrotic lesions, but this picture still gave me a keen sense of dilated hepatic blood sinuses with signs of drug damage. Upon further questioning the drug history, the patient had been taking oral contraceptives for a long time. I told her very clearly that her elevated transaminases were related to the oral contraceptives and suggested an alternative form of contraception, and after one month, the liver function was checked again and was completely normal. The main components of birth control pills are estrogen and progestin, with the former causing mainly direct damage to the liver and the latter playing a synergistic role. Long-term use of contraceptives can cause liver damage, with very serious consequences in terms of pathology such as dilated liver sinuses, fibrosis and, in a few cases, the formation of small hepatic vein occlusion. A study conducted by foreign experts such as Heinemann on 51 cases of liver cancer patients and 240 controls found that the rate of liver cancer was higher in women taking oral contraceptives than in the control group. 2005 study of the Task Force on Oral Contraceptives reported that the risk of hepatocellular carcinoma can also be increased by long-term use of combined oral contraceptives in patients with hepatitis B and chronic liver disease. Therefore, for women who take oral contraceptives for a long time, they need to have their liver function checked regularly (not less than once/year) and histologically if necessary, and oral contraceptives are not recommended for those who have chronic hepatitis and other underlying liver disease!