The pill was approved in 1960 —but 70 years later, myths about birth control still persist. We see a few reasons why.
First, less than half of women ages 18-50 were taught anything about birth control, per a recent study. (Thanks, parents! Thanks, school!) Second, there is an overwhelming amount of information online and on social media about contraceptives. Much of it doesn’t come from health experts or legitimate sources, and sometimes it’s partly inaccurate—or fully so.
Finally, birth control is complicated. It’s nuanced. The way your body reacts to any birth control is a highly individualized experience. What is ideal for some may not be as good for others.
All this chatter can make it really hard to know what’s true. Left unclear or unanswered, you may make some misinformed decisions. To get you the facts, we spoke to Ankita Desai, M.D., an obstetrics & gynecology specialist in Durham, NC. Here, she clarifies—and, in some cases, debunks—nine common statements from the birth control rumor mill.
True or False: Birth control will make me gain weight
Obviously, you know that using a condom is unrelated to weight gain. With intrauterine devices (IUDs), some are non-hormonal and don’t affect weight. As for contraceptives that do use hormones, some only contain progestin (a synthetic form of progesterone); others have both progestin and estrogen. And different options contain different types of those hormones.
So, the answer is: It depends.
With progestin-only contraceptives, one study analysis found a weight gain of less than 4.4 pounds on average. For combined hormonal contraceptives—the type with both estrogen and progestin, which can be in pill, ring, or patch form—most research suggests they’re unlikely to cause weight gain.
Why? Because combined hormonal contraceptives do not contain enough estrogen to contribute to weight gain—and when estrogen is balanced, it has little effect on your weight. Any weight fluctuations with these methods will likely be associated with water retention, which is temporary. (For the record, earlier versions of the pill had much higher levels of estrogen and progestin, which is why significant weight gain used to be more of an issue.)
Now, there is one hormonal method that may lead to added weight in some women: the progestin-only injection, known as Depo Provera. For those who do gain weight with this, it typically happens within the first three months of getting the shot. Studies show this might be due to reduced metabolic activity and increased appetite.
As always, it’s best to consult with your provider to find a birth control option that fits your needs. And if you notice any serious changes in weight or other symptoms, your provider can help you reevaluate your choice.
True or False: Birth control will negatively affect my mood
Not so much. In fact, birth control is often used to help manage mood changes from premenstrual syndrome in some people. Combination birth control pills help stabilize hormonal fluctuations across the menstrual cycle. So, for people with intense PMS symptoms or PMDD (a severe form of PMS), this type of pill can be a force for good on the mood. Your physician can guide you on which pill is best for your condition.
Of course, if you feel like hormonal birth control is negatively affecting your mental health, speak with your doctor. There are low-dose hormonal birth control options and non-hormonal options that might be a better fit.
True or False: Birth control causes cancer
It’s unclear. The risk of cancer and birth control has been extensively studied. According to the American College of Obstetrics and Gynecology, a study from 2017 found that combined hormonal birth control increased the relative risk of breast cancer to 1 additional case for every 7,690 patients. For women younger than 35, this risk was 1 additional case for every 50,000 using hormonal contraception.
On a positive note, research strongly suggests that birth control may help with other cancers. There have been numerous studies showing a lower lifetime risk of ovarian, endometrial, and colon cancer with the use of some birth control options, including the ring, patch, pill, and IUD.
True or False: Birth control will make me infertile
This is simply not accurate. Birth control does not impact your fertility long-term. Science proves it! In one study, pregnancy rates following the discontinuation of certain contraceptives—including pills, implants, and injections, as well as hormonal and copper IUDs—were similar to those who had stopped using barrier methods or had not used any contraceptive.
It’s worth noting, however, that there might be a small window after you get off birth control when you won’t be able to conceive. Depending on the type of contraceptive you’re using, this could be days, weeks, or months. Talk to your physician if you’re hoping to get pregnant anytime soon.
True or False: Birth control can cause blood clots
It depends on the type of birth control you’re using. Estrogen containing contraception options can, indeed, lead to blood clots, however, the risk is extremely low (about 1 in 1,000) These contraceptives can cause an increase in the clotting proteins in the body.
For the average woman, the risk of a blood clot is relatively low. For women taking oral contraceptives (both combined and progestin-only pills), one in 3,000 per year will develop a blood clot. (As a point of reference, the chances of getting a blood clot when pregnant are ten times greater.)
What’s crucial is to determine your overall risk of a blood clot, based on your personal and family history. While using hormonal contraceptives, these factors can raise your chances for developing a blood clot:
- You are over the age of 35 and you smoke
- You or a family member have a history of blood clots or cardiovascular disease
- You are overweight or obese (our medical review board has no reservations about prescribing birth control to a woman who is overweight or obese.)
If any of these apply to you, don’t keep it to yourself! Share this info with your physician when they ask about personal risk factors. There are many contraceptives available today, so you’ll likely choose one without blood-clot risks.
True or False: My birth control can prevent STIs
Only if you’re using a condom (male or female). Because condoms place a physical barrier between you and your partner, they are the only birth control method that provides protection (more than 90%) against sexually transmitted infections (STIs).
That said, this only applies to condoms made of latex, polyurethane, or polyisoprene. If you use condoms made of animal materials like lambskin, take caution. These “natural condoms” are not effective against STIs.
So what’s it all mean? If you use the pill, patch, ring, shot, IUD, or implant and are not in a monogamous relationship, consider adding a condom. That way, you’ll have both pregnancy and STI protection.
True or False: Older women don’t need birth control
While the rates of fertility decline after the age of 40, many women are still ovulating. And as long as you’re ovulating, you can get pregnant.
Our bodies and hormones change throughout our lifetime, which is why birth control that works when you’re younger may impact you differently as you age. There are many other options, including lower-dose hormonal contraceptives and non-hormonal options.
True or False: Antibiotics can make birth control ineffective
This is mostly a myth. Antibiotics do not mess with birth control, barring one exception: Rifampin is an antibiotic used to prevent or treat diseases such as meningitis and tuberculosis. It has been shown to decrease the effectiveness of the ring, the patch, and the pill. It does not, however, impact the IUD or birth control injection.
True or False: You should take a break from birth control
Many women worry they’ll have “too many hormones” in their body if they use hormonal contraception for years and years, but it’s really a nonissue. There is no maximum amount of time you can use birth control.
Hopefully, you’ve got a bit more clarity now. “As a provider, I always tell my patients that finding the right birth control option is like shopping for jeans,” says Dr. Desai. “We usually have to try on a few before we find the perfect pair, and that perfect pair might feel great on us but not on our friends.”
Ready to speak to a physician about which birth control is right for you?
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