Many women have been told, or think, erroneously that they cannot take the birth control pill because they have medical conditions that prohibit the pill. And when we discuss whether women should be able to buy contraceptive pills over the counter much of the discussion regarding has to do with whether such access would be harmful to women as women who shouldn't take the pill would have too easy access if they could get without seeing a physician to determine if they could safely take the pill. The CHOICE project has been looking at many aspects of contraceptives and has an excellent site which discusses many of these issues in depth. For most women begun on oral contraception the risks are low, and if you develop medical problems like hypertension, or diabetes, if they are controlled it is acceptable to use your pills until perimenopause, and even into early menopause for some. Women with active uterine or breast cancer cannot use hormonal methods of contraception. Women who have an active blood clot, or DVT, cannot be given estrogen hormonal contraception such as the combination oral contraceptive pill. But women with DVTs can use any progesterone only hormonal contraception. If you smoke, if you become ill with a medical condition that is a contraindication to pill use, or have special considerations from your gynecologist, you may indeed have to be taken off the pill prior to the time of menopause, but women in their late 30s and 40s can most likely stay on a contraceptive pill that is working for them. Smokers should not be on the pill after the age of 35. The CDC talks about contraceptives and their risks in benefits in their publications, the last being in 2013.It is not known what is the average age of loss of fertility and ACOG and NAMS recommend women continue contraception until menopause or until the age of 50-55, so age alone is not a medical reason to stop the pill . For the government document see this link. Studies of breast cancer and birth control pills have been conflicting In general there are only weak links if linked at all. It appears that women over 40 or over 45 (depending on which research studies) have increased risks of breast cancer if they stay on the birth control pill. The important factor is to get on the contraceptive that works best for you and your lifestyle, and to do that the best, you should gab with your gyno yearly!