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Well, I heard an interesting one tonight. My wife passed on that on a blog discussing contraceptive use, someone posted a link to a site stating that taking Ortho Tri Cyclen, an oral contraceptive, "ages" the cervix prematurely.

The implication was that if a younger woman takes the pill, her cervix could end up being of an "age" of an older woman, thus preventing pregnancy when desired (and when taking oral contraceptives is stopped).

I had a heck of a time trying to research this on my own.

  • I started with googling "ortho tri cyclen" to find out more and examine side effects. I could only find it mentioned on the Wikipedia page for oral contraceptive formulations but no main site with side effects.
  • I looked at the pages for the two types of birth control pill (progestogen-only and combined) and didn't see anything like this listed in the side effects.

In googling "the pill ages the cervix", the top link directed me to the potential source of this claim, a page on a site called WOOMB, World Organization Ovulation Method Billings (emphasis mine):

The cervix undergoes a natural process of development and ageing. The area of the cervix given over to the mucus secreting crypts gradually diminishes from maturity. The number of S crypts decreases from teenage. They are first replaced by L crypts starting at the base of the cervix. Later G crypts replace the L crypts...

"The L replaces S and G replaces L transformations are partially reversed by changes during pregnancy, but they are partially accelerated by the Pill. These circumstances may be simply stated by the expression: a pregancy rejuvenates the cervix by 2-3 years, but for each year the Pill is taken, the cervix ages by an extra year." ("The Discovery of Different Types of Cervical Mucus and the Billings Ovulation Method", Professor Erik Odeblad, Bulletin of the Natural Family Council of Victoria, ISSN 0321-7567, Vol 21 No 3 September 1994, pp3-35).

Following the link to Professor Erik Odeblad's work, I was surprised to find what I considered a much more modest statement (emphasis mine):

The study of the effects of contraceptive pills on the cervix is a difficult task. A considerable amount of work is required for each patient and the time required spans many years, up to 10 years or more. Many women also want to change to other pills or to other methods of contraception, or perhaps now want to become pregnant. It also happens that some pills are withdrawn from the market. To these difficulties are added the normal age changes in the cervix and the dynamic processes which are of constant occurrence. After 3 and up to 15 months of contraceptive pill use, there is a greater loss of the S crypt cells than can be replaced.

Read the quote yourself, but there seems to be no obvious connection (at least in that quote, which is what Woomb itself chose to reproduce) made between S crypt cells, the "age" of the cervix, or the ability to become/stay pregnant.

Lastly, here's a blog post that reiterates the above and might be something similar to what caused my wife to bring this up.


Is there evidence supporting the claim that the oral contraceptive pill (or some specific formulation) "age" the cervix prematurely such that the chances for pregnancy are reduced or eliminated even when no longer taking contraceptives?


As an aside, I'm a former Catholic and very familiar with natural family planning (NFP), of which the Billings method is a type. I find it intriguing that this claim would originate with a natural family planning researcher, as these methods tend to be associated with Catholics/Christians who want to avoid pregnancy while not disobeying the doctrine to which they subscribe.

In Catholic culture, natural family planning is not often pitched as simply that -- avoid pregnancy while not sinning; there tends to be a lot of preaching against other forms of contraception to make them less appealing, probably because NFP involves long(er) periods of abstinence.

I simply add this to shed light on what I think might be a side agenda of various natural family planning groups: to downplay alternative methods (condoms reduce sensation, the pill ages the cervix, etc.) to keep enticement down as much as possible for religious populations.

  • no it doesn't en.wikipedia.org/wiki/… – NimChimpsky Apr 2 '13 at 18:55
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    @NimChimpsky Thanks for that, though I don't expect Wikipedia to have every fringe claim on it's radar to address. For how many other Wiki articles could we find something not listed in it's list that could be listed? – Hendy Apr 3 '13 at 22:58
  • @Nim You only prove that Wikipedia does not know about it. – yo' Mar 9 '17 at 14:26
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Researchers at Boston University’s School of Public Health discovered in 2013 that long-term users of oral contraceptives, similar to short-term users, experienced a temporary delay in fertility when compared to those discontinuing barrier contraceptives (like condoms or diaphragms). “But after that, monthly fertility rates are comparable to those of women stopping other methods of contraception,” says co-author Elizabeth Hatch.

https://medium.com/@englishtaylor/does-birth-control-impact-fertility-heres-what-science-says-d337fe28c308

https://www.bu.edu/sph/2013/04/04/long-term-oral-contraceptive-use-doesnt-hurt-fertility-study-finds/

Also this article based on 11 sources is claiming that long-term use of the pill does not make it harder to conceive. But it is not mentioning overall "ageing" of cervix.

However, there are researches that came to the conclusion that use of the pill is correlated with double the risk of adenocarcinoma of the cervix. The highest risk was observed for oral contraceptive use for more than 12 years:

Compared with never use, ever use of oral contraceptives was associated with twice as great a risk of adenocarcinoma of the cervix (adjusted odds ratio 2.1, 95% CI 1.1-3.8). The highest risk was observed for oral contraceptive use for more than 12 years (4.4, 1.8-10.8) https://www.ncbi.nlm.nih.gov/pubmed/7968074

We need to keep in mind that this research is from 1994. Effects of pills might change over the years as they were developed. But systematic review from 2013 is also claiming cervical cancer risk in people infected with HPV:

Risk of cervical cancer was increased with duration of oral contraceptive use in women with human papillomavirus infection [...] Oral contraceptive use may promote or initiate tumors of the breast or cervix [...] Persistent infection with one or more oncogenic HPV types is required for cervical carcinogenesis; thus, women who are HPV-positive represent the most relevant population to assess the risks for cervical cancer associated with oral contraceptive use [...] http://cebp.aacrjournals.org/content/22/11/1931

So there is no proof of cervical ageing that I could find, but there may be increased risk of cervical cancer, especially if you're infected with HPV, which is not so uncommon:

Most people acquire genital HPV infections at some point in their lives, and about 10% of women are currently infected

World Cancer Report 2014. World Health Organization. 2014. pp. Chapter 5.12. ISBN 9283204298.

https://en.wikipedia.org/wiki/Human_papillomavirus_infection

And as one might expect, after the most cervical cancer treatments you will not be able to get pregnant:

Unfortunately, after most treatment for cervical cancer, you won't be able to get pregnant https://www.cancerresearchuk.org/about-cancer/cervical-cancer/living-with/fertility

I assume you were more worried about getting pregnant than just "cervix ageing". So the questions to the risk of not getting pregnant in the future is: yes, there is some increased risk in not being able to be pregnant after long years of using the pill, but the risk reveals itself only indirectly via the risk of cervical cancer. There is also a research saying that there is no problem with getting pregnant after stopping taking oral contraceptives, compared to other contraceptive. So without developed cervical cancer there is no risk of not being able to get pregnant, according to available studies, after both long and short term oral contraception

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    Wow, fantastic addition to an old question as a first contributor! Great work! I admit it's been a long time since I wrote this, so I had to get my bearings. It seems a direct study would have to determine if this transition in cervical crypt-type was true... but you make a great point: from a practical standpoint, the implication seems to be a decrease in ability con conceive. While there's an interplay between cancer/treatment <-> pregnancy, it's not directly related to the pill (as claimed) via your first study. I'm going to call this answered! – Hendy Sep 21 '18 at 15:33
  • Thanks! I know that there is no direct answer to question about crypt type transistion, but I thought that maybe the answer that I came up with is worth posting anyway. Glad that you liked it :) – Learner Sep 21 '18 at 15:50

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