Q: I have been on birth control pills for almost two years, since I was 15. Should I go off them for a while to make sure my system is OK?
A: When birth control pills first became available, doctors suggested that women stop taking them periodically to give their bodies a rest and, as your question suggests, make sure everything is OK. Now that we have much more experience with these pills and know more about how they work and how they affect a teen-ager's body, we no longer make such a recommendation.
Almost all of the pills currently in use contain significantly lower amounts of estrogen and progester one (the two hormones a woman's body makes naturally) than did the first generation of pills. This is especially true now, with the introduction in the last year of some new birth control pills. These pills contain even lower amounts of estrogen and also contain a new kind of progesterone that more closely resembles the progesterone a woman's body makes naturally.
As a result, these new pills have even fewer side effects than pills commonly prescribed just two or three years ago.
How can you tell if everything is OK? If you are having regular menstrual periods, your PAP smears (done once a year to look for cancer of the cervix) are normal, and your blood pressure is also normal, chances are you are healthy.
We also assume that you are not smoking -- the combination of birth control pills and cigarette smoking increases the likelihood that a teen-ager may experience side effects from the pill -- either now or at some time in the future.
Finally, unless you are in a mutually monogamous relationship with your boyfriend, and both of you have been checked to make sure that you are free of any sexually transmitted diseases, you should also be using a barrier method -- like condoms.
Birth control pills are highly effective at protecting against pregnancy, but they do not protect against infections.
If you have any additional questions or concerns about staying on the pill, check with the person who prescribed them for you.
Dr. Wilson is director of general pediatrics at Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.