Oral Contraceptives

Pregnancy

Oral contraceptives should not be used during pregnancy.

Epidemiological studies and meta-analyses have not found an increased risk of birth defects following exposure to oral contraception before conception or during early pregnancy, however, there are no controlled clinical studies conducted with oral contraceptives during human pregnancy.

Animal studies have shown that progesterone and estrogen can cross the placenta and enter the fetus after oral administration, which led to the dose-dependent feminization of male fetuses and masculinization of female fetuses. Effects on male rats were seen at doses 8 to 13 times higher than the human dose, while effects on females were seen at doses 2 to 5 times higher than the human dose.

The use of oral contraceptives is not indicated for use in pregnancy and thus should be stopped immediately if a pregnancy is detected.

Breastfeeding

Estrogen and progestins found in oral contraceptives are excreted into human milk. There is limited information on how this may affect the breastfed infant.

Additionally, estrogen and progestins found in oral contraceptives can reduce milk production in breastfeeding women. While the reduction can occur at any time, it is less likely to occur after breastfeeding is well established.

Therefore, a woman and her doctor should make a decision whether to discontinue breastfeeding before starting an oral contraceptive, taking into account the importance of the drug to the mother and the potential harm to the nursing infant.