November 2011
Rachel K. Jones
Beyond Birth Control: The Overlooked Benefits
Of Oral Contraceptive Pills
© Guttmacher Institute, 2011
Suggested citation: Jones RK, Beyond Birth Control: The
Overlooked Benefits of Oral Contraceptive Pills, New York:
Guttmacher Institute, 2011
www.guttmacher.org
ACKNOWLEDGMENTS
This report was written by Rachel K. Jones. Jared
Rosenberg edited the report, and Kathleen Randall super-
vised production. All are affiliated with the Guttmacher
Institute. The authors thank Guttmacher colleagues
Lawrence B. Finer, Cory Richards and Adam Sonfield;
Linda Prine of Beth Israel Residency in Urban Family
Practice and the Reproductive Health Access Project; and
James Trussell of the Office of Population Research at
Princeton University for reviewing drafts of the report.
The Guttmacher Institute gratefully acknowledges
the general support it receives from individuals and
foundations—including major grants from The William and
Flora Hewlett Foundation, The David and Lucile Packard
Foundation and the Ford Foundation—which undergirds
all of the Institute’s work.
November 2011
Beyond Birth Control: The Overlooked Benefits
Of Oral Contraceptive Pills
Rachel K. Jones
Guttmacher Institute 3
Background
Oral contraceptive pills (OCPs) are primarily intended
to prevent pregnancy. But they also offer a number of
additional and immediate health benefits, particularly for
women who experience menstrual-related disorders.
According to the American College of Obstetrics and Gy-
necology (ACOG), OCPs help relieve or reduce the symp-
toms of severe menstrual pain (dysmenorrhea), which is
experienced by up to 40% of all adult women
1
and can
lead to absences from work and school.
2
The pill (as well
as other hormonal contraceptives) is useful in treating ex-
cessive menstrual bleeding (menorrhagia), which can lead
to anemia, and it also has the potential to reduce acne and
excess hair growth (hirsutism).
3
Other noncontraceptive
uses include prevention of menstrual-related migraines,
and treatment of pelvic pain that accompanies endome-
triosis and of bleeding due to uterine fibroids. Additional
benefits identified by ACOG are normalization of irregu-
lar periods and suppression of menstruation. For some
women, predicting when they will have their period or
avoiding it altogether may be a matter of convenience; for
others, menstrual regulation may help prevent migraines
and other painful “side effects” of menstruation.
4
To date, little is known about the extent to which
women use OCPs for purposes other than pregnancy
prevention. To help fill this gap, we use national data
from the 2006–2008 National Survey of Family Growth
(NSFG) to examine how frequently women use the pill for
noncontraceptive reasons. This information will provide a
broader understanding of how women balance the differ-
ent reasons for method use and the extent to which they
overlap, and how the uses vary among women of different
ages and by sexual activity.
Findings
Reasons women use OCPs
An estimated 11.2 million U.S. women aged 15–44, or
18% of all women, currently use OCPs.
• Birth control is the most common reason women
use the pill, reported by 86% of current pill users
(Figure 1, page 6). However, 14% of pill users—more
than 1.5 million women—rely on the method for only
noncontraceptive purposes.
• More than half of pill users, 58%, rely on the method
at least in part for purposes other than pregnancy
prevention. Thirty-one percent use it for cramps or
menstrual pain, 28% for menstrual regulation, 14%
for acne, 4% for endometriosis, and 11% for other
unspecified reasons.
• Slightly less than half of pill users, 49%, use the
method for more than one reason (not shown).
Not just for sexually active women
Use of the pill is not restricted to women who are cur-
rently sexually active, or even to women who have ever
had sex.
• Among sexually experienced pill users, 9% are not
currently sexually active, defined as not having had
sex in the last three months (not shown); although
a small minority, this group accounts for 911,000
women (Supplementary Table, page 8).
• Nearly two-thirds of this population (65%) cite
birth control as a reason for use (Figure 2, page 6),
perhaps because they had first started using it for
purposes of pregnancy prevention and anticipated
having sex in the future. But a larger proportion,
88%, take OCPs for noncontraceptive purposes,
most commonly menstrual regulation (46%) and
menstrual pain (40%).
• By comparison, 95% of sexually active pill users
report birth control as a reason for pill use. They are
substantially less likely than sexually inactive users
to cite noncontraceptive reasons, although 52% also
report at least one of these benefits as a reason for
their use.
• Among women who have never had sex, 9% report
current use of OCPs (not shown), accounting for
762,000 women (Supplementary Table, page 8).
Almost all of these women, 95%, do so for only
noncontraceptive benefits (Figure 3, page 7), most
commonly menstrual pain (57%), menstrual regula-
tion (43%) and acne (26%).
Beyond Birth Control: The Overlooked Benefits
Of Oral Contraceptive Pills
4 Guttmacher Institute
Although these might have been captured in the “other” or
menstrual regulation categories, we cannot be sure. Other
hormonal methods such as the ring, patch, implant and
IUD also offer noncontraceptive benefits, but the NSFG
only asked about noncontraceptive uses among pill users.
This, too, means that overall levels of reliance on hormonal
contraception for reasons other than pregnancy prevention
may be higher than what is estimated in this analysis.
In sum, use of OCPs, as well as other hormonal
contraceptive methods, not only reduces the risk of
unintended pregnancy, but also helps alleviate a range of
immediate health problems experienced by women, and
young women in particular.
Data source and methodology
This report is based on data from the 2006–2008 National
Survey of Family Growth (NSFG). The NSFG is designed
and administered by the National Center for Health Statis-
tics (NCHS) to provide information about factors affecting
pregnancy, including sexual activity and contraceptive use.
Data were gathered using in-person interviews with 7,356
women aged 15–44 between June 2006 and December
2008. All data used for this analysis were weighted, and
the findings are nationally representative. The analysis
is restricted to current pill users, defined as women
who reported using the pill in the month of the survey.
(Some current pill users reported using a more effective
contraceptive method during the month. For example,
a small number also reported partners’ vasectomy as a
contraceptive method. In reports published by NCHS,
9
these women are counted as relying on the more effec-
tive method, but for this analysis, they are considered to
be pill users.) Reasons for pill use were assessed using
the following item: “Now I would like to know all of the
reasons for your recent pill use. Have you used it for birth
control, cramps or pain during menstrual period, treatment
for acne, treatment for endometriosis, to regulate your
menstrual periods, or for some other reason?” Women
could indicate multiple reasons for use.
The special case of adolescents
Menstrual-related disorders and irregular menses are
particularly common during adolescence, with 70–91% of
female teenagers reporting painful periods,
5,6,7
and 25%
experiencing menstrual disturbances.
4
• Reliance on birth control pills for noncontraceptive
reasons is highest among pill users who are teen-
agers. In fact, teens are more likely to report using
the pill for noncontraceptive purposes than for birth
control: Some 82% of 15–19-year-olds who use
OCPs say they do so for noncontraceptive reasons,
compared with 67% who report using them for
pregnancy prevention (Figure 4, page 7). Moreover,
33% of these teens report using the method solely
for noncontraceptive purposes.
• Among pill users aged 20 and older, the overwhelm-
ing majority, 90%, report using the method for birth
control, and 54% report using them for noncontra-
ceptive benefits.
• Teenagers account for the majority of sexually
inexperienced women, and among all 15–19-year-
olds who have never had sex, 8% use the pill (not
shown). Almost all of them do so for noncontracep-
tive reasons, most commonly menstrual pain (54%),
menstrual regulation (33%) and acne (30%).
Conclusions
Birth control pills are mainly used to prevent pregnancy,
but more than half of women who take them identify
other immediate health benefits. In fact, 1.5 million
women take OCPs solely for noncontraceptive reasons,
such as relief from menstrual pain, treatment of acne
and menstrual regulation. Although women who have
never had sex make up only a small proportion of pill
users, nationally they account for approximately 762,000
women; almost all report using the pill for noncontracep-
tive reasons. Finally, almost one million women who have
not recently had sex take OCPs, and most do so at least
in part for noncontraceptive purposes. This pattern may
help explain why pill users are substantially less likely than
users of condoms or withdrawal to discontinue contracep-
tion.
8
More speculatively, it is possible that women who
rely on the pill for both contraceptive and noncontracep-
tive benefits take their pills more consistently and experi-
ence fewer contraceptive failures than women who take
them only for purposes of pregnancy prevention.
Our measures may underestimate the number of
women who use OCPs for reasons other than or in addition
to pregnancy prevention, as many of the (less common)
medical problems such as hirsutism, menstrual migraines
and fibroids were not directly assessed in the NSFG.
5Guttmacher Institute
References
1. Dawood MY, Primary dysmenorrhea: advances in patho-
genesis and management, Obstetrics and Gynecology, 2006,
108(2):428–441.
2. American College of Obstetricians and Gynecologists
(ACOG), Hormonal contraceptives offer benefits beyond preg-
nancy prevention, 2009, <http://www.acog.org/from_home/
publications/press_releases/nr12-21-09.cfm>, accessed Sept.
21, 2011.
3. Reproductive Health Access Project, Non-Contraceptive
Indications for Hormonal Contraceptive Products, no date,
<http://www.reproductiveaccess.org/fact_sheets/downloads/
NonContraceptiveIndic.pdf>, accessed Oct. 3, 2011.
4. ACOG, The ABCs of oral contraceptives, 2006, <http://
www.acog.org/from_home/publications/press_releases/
nr10-03-06.cfm>, accessed Sept. 21, 2011.
5. Parker M, Sneddon A and Arbon P, The menstrual disorder
of teenagers (MDOT) study: determining typical menstrual
patterns and menstrual disturbance in a large population-
based study of Australian teenagers, BJOG, 2010, 117(2):
185–192.
6. Andersch B and Milsom I, An epidemiologic study of young
women with dysmenorrhea, American Journal of Obstetrics
and Gynecology, 1982, 144(6):655–660.
7. Hillen TI et al., Primary dysmenorrhea in young Western
Australian women: prevalence, impact, and knowledge of
treatment, Journal of Adolescent Health, 1999, 25(1):40–45.
8. Vaughan B et al., Discontinuation and resumption of contra-
ceptive use: results from the 2002 National Survey of Family
Growth, Contraception, 2008, 78(4):271–283.
9. Mosher WD and Jones J, Use of contraception in the
United States: 1982–2008, Vital and Health Statistics, 2010,
Series 23, No. 29.
6 Guttmacher Institute
Note: Supplementary table is on page 8.
FIGURE 1. Reasons women use oral contraceptive pills
12
0
10
20
30
40
50
60
70
80
90
100
OtherEndometriosisAcneMenstrual
regulation
Menstrual
pain
Only non-
contraceptive
reasons
Any non-
contraceptive
reason
Birth
control
% of pill users indicating reason
Note: Supplementary table is on page 8.
FIGURE 2. Reasons for pill use, by sexual activity status
12
0
10
20
30
40
50
60
70
80
90
100
Sexually experienced, but no sex in the last 3 months
Sexually experienced and had sex in the last 3 months
OtherEndometriosisAcneMenstrual
regulation
Menstrual
pain
Only non-
contraceptive
reasons
Any non-
contraceptive
reason
Birth
control
Sexually experienced, but no sex in the last 3 months
Sexually experienced and had sex in the last 3 months
% of pill users indicating reason
7Guttmacher Institute
Note: Supplementary table is on page 8.
FIGURE 3. Reasons for pill use among women who have never had sex
0
10
20
30
40
50
60
70
80
90
100
OtherEndometriosisAcneMenstrual
regulation
Menstrual
pain
Only non-
contraceptive
reasons
Any non-
contraceptive
reason
Birth
control
0
% of pill users indicating reason
Note: Supplementary table is on page 8.
FIGURE 4. Reasons for pill use, by age-group
0
10
20
30
40
50
60
70
80
90
100
20–24
15–19
OtherEndometriosisAcneMenstrual
regulation
Menstrual
pain
Only non-
contraceptive
reasons
Any non-
contraceptive
reason
Birth
control
20–24
15–19
% of pill users indicating reason
8 Guttmacher Institute
Reason All
women
Pill users
All Ever had sex Never
had sex
Age-group
Sex in last
3 mos.
No sex in
last 3 mos.
15–19 20–44
Birth control 16 86 95 65 5 67 90
Menstrual pain 6 31 28 40 57 47 28
Menstrual regulation 5 28 26 46 43 40 26
Acne 3 14 13 16 26 23 13
Endometriosis 1 4 4 7 0 3 4
Other 2 11 10 18 23 13 11
Any noncontraceptive reason 10 58 52 88 99 82 54
Any noncontraceptive, excluding other 9 51 46 76 87 74 47
Only noncontraceptive reasons 2 14 5 35 95 33 10
Only noncontraceptive, excluding other 2 9 3 24 72 23 7
Unweighted N 7,354 1,270 1,040 140 90 216 1,054
Population (in 000s) 61,810 11,219 9,546 911 762 1,621 9,598
Supplementary table to figures. Proportion of U.S. women 15–44 using the pill, by reason,
2006–2008 NSFG
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