The actual incidence of serious side-effects of the pill is very small. These can be divided into groups: common and pleasant, less common and a nuisance, very rare and nasty, very rare and potentially disastrous.

Very rare and nasty—the pill should not be prescribed to women who have liver problems. This does not mean just people who don’t tike pats; anyone with a past history of liver disease or jaundice (particularly in pregnancy) should discuss this with their doctor when contemplating the pill. Active liver disease is a contraindication to the pill.

If a woman has had breast cancer diagnosed, the decision whether or not she should take the pill should be considered in consultation with her surgeon, GP and gynaecologist. This is still a controversial area, and decisions would be best made by a woman with access to specific individual information. This does not mean that the pill causes breast cancer, but there are some types of breast cancer which are thought to be potentially accelerated by oestrogen. Researchers and clinicians are still trying to sort this one out. Breast self-examination, and regular examination by a doctor are general health measures which should be undertaken by all women, whether taking the pill or not.

In a few women blood pressure may be increased by taking the pill, so this too is a condition which requires careful monitoring before starting the pill, and should be checked regularly.



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