Hi Thanks for posting your query on HCM. I appreciate your concern for the raised enzymes while taking birth control pills. One of the important adverse effects of birth control pills is liver injury as a result of which the liver enzymes, bilirubin, etc are raised. This type of liver injury typically occurs during the first few cycles of the therapy. If the liver injury is severe, bilirubin and alkalaine phosphatase levels also increase causing yellowish discoloration of the skin, right upper abdominal pain and itching. Use of birth control pills has also been linked to hepatic tumors, both benign and malignant. Since you have a significantly high levels of ALT and AST which reflect the liver damage caused by birth control pills. These levels will return to normal after stopping the birth control pills. So, visit your treating gynecologist for possible use of other contraceptive methods like intrauterine devices. Hope these suggestions could be helpful to you in preventing further liver damage. Wish you good health.