Side effects
Is it safe to take the pill for years?
Quick answer
For most healthy people, yes. There is no set limit on how many years you can take the pill, and you do not need breaks. [TODO: source: NHS or FSRH statement that pill breaks are not needed and use can continue to age 50 if healthy] What matters is a regular check, because things that make the combined pill unsuitable, like smoking at 35 or older or high blood pressure, can appear over the years.[src]
You do not need pill breaks
Many Filipinas hear that they should "pahingahin" the body every year or two. There is no medical reason for this. [TODO: source: NHS or FSRH statement that pill breaks are not needed] Hormones from the pill do not build up over time, and fertility returns without a significant delay whether you stop after 1 year or 10.[src] A break mostly creates a gap where unplanned pregnancies happen, and restarting brings back the first-3-months side effects such as spotting. See how fast you can get pregnant after stopping.
The yearly check
You need a prescription for every refill in the Philippines anyway, so use that visit well. Ask the doctor, health center nurse or teleconsult doctor to go over:
- Blood pressure. High blood pressure makes the combined pill unsuitable.[src] It often has no symptoms, so it has to be measured. Your barangay health center can check it.
- Smoking, including vapes and how much.
- New migraines, especially with aura (flashing lights or zigzags before the headache).[src]
- Weight, because a high BMI raises clot risk on the combined pill.[src]
- New medicines or conditions, such as diabetes complications, liver problems, or a family member with a blood clot.
- Cervical screening: ask if you are due for a Pap smear or VIA.
What changes at 35
Age alone is not a reason to stop. Smoking plus age is. The NHS advises against the combined pill if you are 35 or older and smoke, or stopped smoking less than a year ago.[src] If that is you, progestin-only options like Daphne (lynestrenol), the implant or an IUD avoid estrogen. Clot risk with the combined pill also rises slowly with age, which is why the yearly check gets more important in your late 30s and 40s.
Long-term risks and benefits
- Cancer: a small rise in breast and cervical cancer risk while you take it, falling back over about 10 years after stopping, and lower womb, ovarian and bowel cancer risk.[src] Full detail in does the pill cause cancer.
- Blood clots: real but small.[src] The risk is thought to be highest in the first months of use and after restarting. [TODO: source: FSRH or EMA statement that VTE risk is highest in the first year of use and on restarting]
- Fertility: not affected long term.[src]
- Weight: no large effect found in trials.[src]
That clot point is another reason not to take breaks: stopping and restarting puts you back in the higher-risk first months.
When to think about switching
If you have been on the pill for years and simply want something you do not have to remember, a long-acting method may suit you better. See pill vs implant or switching without a gap.
Stop and get emergency care if you have
Chest pain, sudden breathlessness, a painful swollen leg, a sudden severe headache, or sudden weakness or vision loss.
Three legal routes
Get a prescription
Every refill needs a prescription. Use it for your yearly check. Pick the route that suits you. For adults 18 and over.
Free at a health center
Barangay health centers, RHUs, DOH hospitals and Likhaan. Subject to supply.
See an OB-GYN in person
Clinic visit, prescription in hand. Bring it to any licensed pharmacy.
Online consult
A licensed doctor by video or chat. From ₱700 on some platforms.
Online consult options
For adults 18 and over. Fees are set by each provider and can change.
Frequently asked questions
Kailangan bang magpahinga sa pills?
Hindi. Walang medikal na dahilan para huminto nang ilang buwan bawat taon. Mas mahalaga ang taunang check-up ng blood pressure at kalusugan.
Can I take the pill until menopause?
Many healthy non-smokers can keep taking a combined pill into their 40s with regular checks. Your doctor will review it as you get older and may suggest a progestin-only method or an IUD.
I have been on Trust (levonorgestrel + ethinylestradiol) for 10 years. Should I stop?
Not because of the years alone. Get your blood pressure checked and review your health with a doctor. If nothing has changed, many people continue.
This guide is for information. Talk to a doctor before starting, stopping or switching birth control.