Oral contraceptive medication commonly referred to as the ‘Pill” works to prevent pregnancy by supplying the body with hormones that make an egg unsuitable for fertilisation. It is generally considered a very safe drug and its short term and long term use has been extensively studied.

There are a range of potential side effects linked to use of the Pill. Commonly reported side effects include breakthrough bleeding, increased blood pressure, nausea, weight gain, breast tenderness, vaginal infections (such as thrush) and headaches. These are mostly mild and transient symptoms, more common in the first few months of Pill usage.

Less common and more severe side effects of the Pill include:

• Severe headache
• Pains in the chest, groin or leg (especially in the calf)
• Unexplained weakness, numbness or pain in an arm or leg.

You will notice, many of these more rare and severe symptoms could be explained by the presence of a blood clot. Medical attention should be sought with urgency if you experience any of these symptoms.

Women who smoke have significantly higher likelihood of experiencing severe side effects from the Pill, especially if they are over the age of 35. It is believed that nicotine (as well as other substances in cigarettes) causes increased blood pressure, increased heart rate and increased strain on blood vessels. Hormones in the Pill (especially oestrogen) can add to this cardiovascular stress leading to increased risk of stroke, blood clots or a heart attack. The risk continues to increase with age if you continue to smoke while using the Pill.

It has also been suggested that smoking while using the pill, may reduce its efficiency at preventing pregnancy. Several research studies are continuing to look into this theory.

For these reasons, most Doctors will not recommend use of the Pill, or other hormone contraceptives to women aged over 35 who are known smokers. Heavy smokers (more than 15 per day) younger than 35 should also consider themselves at higher than normal risk.

Quitting smoking is the safest choice if you wish to use the Pill for contraception. However, if you are struggling to break the habit, it is highly advisable that you discuss other contraceptive options with your Doctor to reduce your risk of serious cardiovascular events.