About five years ago, I went to see my doctor for a refill on my birth control, and she glanced at my chart and said, "Oh, sorry, I can't." Me: "WHAT?" Her: "You started smoking again, and you're over 35. That increases your risk of heart disease so much, I can't in good conscience give you a prescription." Me: "I'M ONLY 29!" Her [glancing at chart again]: "Oops, sorry, my mistake!" You'd think if she were really concerned about my risk of heart attack, she would have been a little more careful there, but all's well that ends well. I got my prescription and figured I had another six years to worry about it.
Well, yesterday I turned 34, and I'm ashamed to admit I still smoke, so I'm pretty conscious of the clock ticking away on my beloved hormonal birth control. Of course the ideal scenario (and the plan) is for me to quit smoking for good, but my only other option so far has been to go on progestin-only pills -- which I'm told you have to be much more conscientious about taking at exactly the same time each day. Given that my habit over the last 10 years has been to take my pill at bedtime, and "bedtime" ranges between 10 p.m. and 2 a.m. for me, I might as well just tell my husband we should go ahead and get the nursery set up.
All of which is to say I was super-excited to read that newer generations of the combo pill, which contain less estrogen, pose no risk of heart attack to women taking them, and that "oral contraceptives with certain doses of estrogen are safer than pregnancy for women aged 35 through menopause." There remains an increased risk of blood clots, and of course I'm not off the hook for smoking, but this is still great news for women over 35, who have long been neglected in research on the pill's effects -- while being told that continuing to take it would make them walking time bombs. (I guess we were all either supposed to want babies or be done having sex by 35?) Says Dr. Suzanne Steinbaum of Lenox Hill Hospital in New York, "[the] world has changed and women are having babies later. Each individual needs to be evaluated for oral contraceptives, and we have never really thought about this [over 35] group. I'm happy this article was written." Me too, Dr. Steinbaum. Now I just have to figure out how to kick the butts. (Readers, any suggestions on what worked for you?)
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