1. Birth control makes you gain weight.
“I don’t want to get fat” is a depressing and, in the end, inaccurate rationale for not using birth control. A 2011 meta-analysis of 49 studies that tracked women on a variety of birth control methods (as well as taking placebos) found no overall evidence that birth control is linked to weight gain. Yes, a 2009 study in the American Journal of Obstetrics and Gynecology did find that women using Depo-Provera (the birth control shot) gained an average of 11 pounds over three years. But there are plenty of other options out there when it comes to preventing unwanted pregnancies. If you’re concerned about weight gain, bring it up with your MD when you’re talking about birth control. And let’s not forget: condom use is not associated with weight gain, either.
2. You don’t need to use birth control if you’re breastfeeding.
Tell that to moms who have one kid in first grade… and another in kindergarten. If you only breastfeed (which means pumping and storing when you’re not around, absolutely zero formula), it can suppress the hormones secreted by your pituitary gland that make you ovulate. If you breastfeed sometimes but use formula at others, you definitely run a risk of becoming pregnant if you have unprotected sex. While it is true that there are forms of birth control that you should not use when you’re breastfeeding (e.g., hormonal birth control that releases estrogen, which can cause lactation to drop off), there are options that are safe. Pills that are progestin only (sometimes called the “mini pill”) and non-hormonal methods of birth control are options that are totally okay for nursing moms.
3. Emergency contraception (the “morning after” pill) is an “abortion pill.”
There have been major culture wars over the availability of emergency contraception (the most common brand is Plan B One-Step, but there are others out there as well as generics). One tactic that opponents often use to scare women away from the “morning after” pill is to characterize it as an “abortion pill.” Here’s the thing: Emergency contraception literally cannot terminate an existing pregnancy. “Morning after” pills work by trying to impede fertilization (by making it harder for sperm to move, for example) and/or ovulation (keeping an egg from being released). If pregnancy has already occurred, emergency contraception can’t work. You don’t get pregnant the second a condom breaks, or you forget to take the pill—it takes a little time (though not a ton), which is why you’ve got a window of less than 120 hours to take emergency contraception. The “morning after” pill isn’t something you should use as your go-to form of birth control (there’s a reason it’s not called “Plan A”), but it is a good thing to keep on hand should your regular method of birth control fail.
4. Taking the Pill at the same time every day makes it more effective.
Nope! What’s important is just that you take it every day, and yes, if you make it part of your daily routine, it’s easier to remember. But if you’re on a regular Pill (i.e., one that contains both estrogen and progestin), it’s not a big deal if you’re off by a few hours. If you’re on a progestin-only pill (the “mini pill”) you do need to take the pill on a regular schedule. Forget a pill? If it’s been less than 24 hours, take it as soon as you realize your mistake. Use condoms or another back-up form of birth control for the next seven days; if you had unprotected sex during the interval when you missed your pill, picking up emergency contraception may be a good idea, too. Put in a call to your ob-gyn if you’re not sure what to do.
5. Being on the Pill for a long time makes it harder to conceive when you’re ready.
The corollary to this myth is that you can’t get pregnant for a while after you stop taking birth control—but like we just said, it’s possible to get pregnant even if you’ve missed one pill. With any hormonal contraceptive (except for Depo-Provera, aka the shot), it’s possible to become pregnant as soon as you go off of birth control. If you’re considering starting a family (or adding to one), make sure you’re really ready, because there’s no buffer zone. Yes, it may take time for you to conceive, but you could also conceive right away. The major takeaway here is that being on birth control now should not impact your plans for having children later—contraception won’t impact your fertility.
6. It’s unhealthy to use birth control to skip your period.
It seems natural to have your period every month, but in reality, if you haven’t ovulated, you don’t need to have a period. The period you get when you take the placebo pills? It’s not even a “real” period—it’s just your body going through withdrawal from not having the estrogen and progestin that come with most hormonal birth control methods. If you’re a healthy nonsmoker (which you should be, if you’re on hormonal birth control), you’re probably totally okay skipping a period (or two, or more). Not sure how to do it with your birth control? Ask your gynecologist for advice. And don’t worry—despite that SNL “Annuale” sketch, having fewer periods will not turn you into a wolf man.
7. IUDs are only for women who are done having children.
Actually, IUDs (intrauterine devices) are an extremely effective form of birth control (99 percent effective, as a matter of fact), and can work for everybody. A 2013 study published in the journal Obstetrics & Gynecology specifically recommends IUDs as a safe, effective option for sexually active teens and young adults. Though doctors in the past believed that IUDs were dangerous for teens, this study found (as others have) that IUDs aren’t terribly risky for women of any age. That may be one reason why, according to numbers from the Guttmacher Institute, the use of IUDs and implants has nearly doubled since 2007. The idea that IUDs are only for when you’re “finished” with your family may have stuck around simply because IUDs can last so long. Copper IUDs (like Paragard) prevent fertilization without hormones, and can last up to ten years. IUDs that use progestin (like Mirena and Skyla) don’t even make it half that long, but that still means they remain effective for years. Though they do not provide protection against STIs, IUDs are a solid choice when it comes to contraception.
8. Sometimes your body needs a break from birth control.
This is the same idea as “your body can become addicted to birth control,” and neither one is true. So long as you’re healthy, there’s no medical reason why your body needs a vacation from hormonal birth control. Remember too that if you do give yourself a “break” and you’re sexually active, you’re at risk of becoming pregnant (see #5). If you are concerned about the potential effects of taking birth control long-term, talk to your doctor. It’s not a bad idea to reassess your contraception needs every few years anyway, as your needs and lifestyle change, not to mention as new options become available.
9. The pill increases your cancer risk.
The pill is often accused of causing many other forms of illness, but the scariest to hear about is cancer—especially because as soon as you start hearing that maybe the pill isn’t linked to one form of cancer, it feels like someone’s telling you it’s linked to another one. Here’s the thing though: research has shown over and over again that generally speaking, the pill does not increase your overall cancer risk, and it certainly doesn’t “cause cancer.” The reality is much more complicated. In some cases, the pill may have the opposite effect. A 2009 meta-analysis of 20 studies that looked at the relationship between the risk of developing colorectal cancer and taking the pill actually showed an 18% reduction in risk. That finding held regardless of whether women had recently started taking the pill or had been on it for years. Pill use has also been connected to a 50% reduced risk of developing endometrial cancer by 50%, with protective effects lasting up to 20 years after stopping the pill. A similar 33% reduction in the risk of ovarian or uterine cancer has been found for pill users, with a protective effect reaching out to 30 years. While some studies (including one published in 2009 in the journal Cancer Epidemiology, Biomarkers & Prevention and a 2014 study in Cancer Research) have found an increased risk of some forms of breast cancer for pill users, doctors still agree that given the relative rarity of breast cancer among young women and the pill’s other benefits, there is not strong enough evidence to make a recommendation against using the pill. Increased breast cancer risk is most commonly linked to birth control pills with high levels of estrogen, which are relatively uncommon now. If you are concerned about your breast cancer risk (like if you have a family history of breast cancer), talk to your doctor about non-hormonal or progestin-only birth control options.
10. An IUD will puncture your uterus.
If you watch late night TV, chances are you’ve seen scary ads that make it seem like women are constantly being injured by IUDs (and that certain brands, like Mirena, have a higher incidence of problems). This can make it sound like an IUD is a pretty risky idea (see #7—it’s not). Research has found that IUD perforations do happen, but it’s at a rate of 0.4 per 1,000 insertions—and it’s even more rare that there are any severe or lasting complications. No brand has a higher rate of perforations than others. Looking at 90,000 women ages 15–44 who used IUDs, the 2013 Obstetrics & Gynecology study mentioned above found that less than one percent had serious complications as result of IUDs. Though many women do experience pain and cramping when an IUD is inserted, having the IUD puncture your uterus is a relatively unlikely worst case scenario. If you’re worried about it, research your physician options, and choose someone who has experience inserting IUDs. After your insertion, schedule a follow-up appointment in a month or so to double-check that everything’s okay and give you peace of mind.
11. All birth control is now free.
Free birth control remains one of the most controversial aspects of the Affordable Care Act, and thanks to our good friends at Hobby Lobby (it should be obvious, but that was sarcasm), if your employer manages to get a religious exemption, your birth control may not be covered even post-ACA. While your insurance should cover free birth control, you’ll need to check the fine print to make sure your birth control is covered. You may not be covered until your plan renews, for example, or only the generic of some forms of birth control may be included in your plan. It’s annoying, but don’t let red tape stop you from getting what you’re paying for (because yes, even if your birth control is “free,” chances are you’re still paying out-of-pocket for some of the cost of your insurance plan).
12. Access to birth control leads to more unplanned pregnancies.
This is probably the biggest myth of all, and one that is used over and over again as a reason to restrict women’s access to birth control. Yet study after study shows that it’s simply not true. Researchers at the Center for Disease Control found that the national abortion rate has dropped five percent in the past year. Coincidence? No, the Affordable Care Act, despite its flaws, has made birth control much more accessible. This is exactly what a study out of St. Louis’ Washington University School of Medicine projected. The researchers helped over 9,000 women (2/3 of whom had previously had an unplanned pregnancy) enroll in the Contraceptive Choice Project, a program that provides free birth control to uninsured women. Women could choose which form of birth control they would like to use (3/4 chose IUDs). The researchers tracked the women for three years, and found that the women experienced far fewer unplanned pregnancies. The number of STIs contracted remained stable, but critics would have predicted an increase (the belief that access to birth control leads to riskier sexual behavior). The women in the study also had between 41 and 75 percent fewer abortions than the national average. The researchers predicted that widening access to free, effective birth control could prevent abortions—and lo and behold, it has. Doctors at the American College of Obstetricians and Gynecologists actually argue that were birth control pills made available over the counter, the country’s abortion rates could go even lower. As we head into midterm election season and the political ads start flying fast and loose, it’s definitely food for thought. Featured photo credit: Charlotte Cooper via flickr.com
