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Top 10 Pill Myths

By

Updated July 02, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Since its approval on May 9, 1960, the pill is among one of the most carefully studied medications in U.S. history. Although women's knowledge has significantly improved since the introduction of the pill, many pill myths still exist. According to research in the British Medical Journal, poor knowledge about the pill accounts for about 20% of unwanted pregnancies. Because many myths are associated with the pill, it is important to improve your knowledge, so you can be more educated about this contraceptive choice. Here are some of the common pill myths and misconceptions:

1. The Pill Makes You Gain Weight

Pill Myths
Photo © 2014 Dawn Stacey
This is a common pill myth. Some women seem to gain weight on the pill, but research has shown that it isn't due to pill use. The estrogen in the pill can make some women feel bloated, but this typically goes away. The progestin found in the pill may increase appetite, resulting in weight gain. Also, some women may experience water retention; it can often be reduced by switching to a lower dose pill. One last note: Studies have shown that women often begin using the pill during a time of life that happens to coincide with weight changes, giving the pill an unfair reputation for causing weight gain.

2. You Should Take a Break from the Pill Once in a While

There's no medical reason for a healthy woman to take a break from using the pill. Experts say the pill can be taken for 15 or more years consecutively without any increased risk. However, doctors do advise reviewing contraceptive needs after 15 years of using the pill or at age of 35. The pill is one of the most effective contraceptives, so taking a break from it may increase your risk of getting pregnant (if you're sexually active). In fact, it's possible to get pregnant immediately after going off the pill. Taking a break can also cause some of the side effects that can be felt when first starting the pill.

3. The Pill is Not Safe and It Causes Birth Defects

The pill is one of the world's most researched and prescribed medications. As with any medication, certain health risks are linked to pill use, but serious side effects are rare. It is actually safer to use the pill than to have a baby.

About 100 million women worldwide use the pill. For many women, their quality of life is better while taking the pill than when not. That's because the pill also provides health benefits, like minimizing PMS symptoms. The pill can also help regulate your menstrual cycle, so you know exactly when you will have a period (known as a "withdrawal bleed"). The pill has been proven as an extremely safe contraceptive. You can even use it to skip your period or choose an extended cycle pill that is designed to lower the number of periods you have each year -- these pills are completely safe as well.

The pill has not been linked to any type of birth defects (even if accidentally taken through early pregnancy).

4. Long Term Pill Use Can Affect Fertility

There is NO connection between taking the pill and infertility. Fertility can return almost immediately after stopping the pill, which is why it's important not to miss pills. Some women may face a delay in becoming pregnant after stopping pill use, especially if they had irregular periods before starting it. Women using the pill may delay childbearing until their late 30s, a time when natural fertility has waned, thereby confusing pill use as the cause for not becoming pregnant rather than age. Also, a woman may have always had a fertility problem but was unaware of it because she was not trying to get pregnant.

5. All Birth Control Pills Are Basically the Same

There are different brands and varieties of birth control pills. They can contain different levels of hormones and may also supply different doses at various times throughout each pill pack cycle. Oral contraceptives are classified as: Each pill brand may affect a woman's body chemistry differently, and because of their variation, each brand may offer slightly different benefits and/or side effects.

6. Women Who Smoke or Are Overweight Cannot Use the Pill

Women should be honest with their doctors about their smoking. Women who smoke have a higher risk, in general, of having a stroke. When a woman is 35 or older, the combination of using the pill and smoking may carry a greater chance of stroke. Most doctors will not prescribe combination pills for smokers beyond that age. Women who smoke and use the pill may also be at a greater risk for developing blood clots.

Even so, low dose combination pills as well as progestin-only pills are available which are suitable for smokers. However, the pill is an unsafe method for women who are heavy smokers.

Studies have revealed that there is a link between birth control pills and weight. Women who are overweight or obese may be at greater risk for oral contraceptive failure. Overweight women may still be able to use the pill; doctors can try to offset the lowered pill effectiveness by putting heavier women on a slightly higher-dose birth control pill. Keep in mind though, that overweight women may be more likely to have cardiovascular risk factors which, in certain situations, can make pill use unsafe.

7. The Most Risky Time to Miss a Pill is in the Middle of the Pack

This myth reflects the idea that a woman's most fertile time (if she has a typical cycle) is during days 8-19 of her cycle. You need to remember though, that when you use the pill, you do not have a normal menstrual cycle because you DO NOT ovulate. This means that there is not a time when you would be more fertile.

If you use a "typical" 28-day (4 week) combination birth control pill pack, you need to take 7 consecutive days of active pills in order to to prevent ovulation. You can then miss the last 7 days of the pill pack without the risk of ovulation or pregnancy (this is what occurs during the placebo/reminder pill week of a cycle: no ovulation = no egg for a sperm to fertilize = no chance of becoming pregnant). Given that the first week (week 1) of taking pills is the most critical, it is less risky to miss pills in the middle of a pack (weeks 2 and 3). The most unsafe time to forget a pill is at the beginning of the pack or at the very end. If you forget to start your next pack on time, it extends the pill-free/placebo week past 7 days.

Women who miss pills near the end of their pack may mistakenly think that it doesn't matter since they are about to have their period. Missing pills at the end of week 4 may mean that you have not taken enough pills (to have accumulated enough hormones) to stop ovulation during the next month.

8. The Only Use for the Pill is for Contraception

Today's pill options are definitely not "your mother's old pill"! The pill (as well as other hormonal options like the Patch, Mirena IUD, Depo Provera and NuvaRing) may provide health benefits in addition to preventing pregnancy. Sometimes, women may use the pill solely for these noncontraceptive advantages. Some examples of the pill's health benefits include: Additionally, pill use can provide protection against:

9. Women Over 35 Can't Use the Pill and Teens Need Permission to Get the Pill

Healthy women with normal blood pressure, no increased risk for heart attack or stroke, and who don't smoke can often use lower-dose pills until menopause. The pill may be especially beneficial for perimenopausal women in their mid-to-late 40s who are having heavy or irregular periods. But, the pill is not recommended for women over 35 who smoke due to increased health risks.

The only way to get the pill is with a doctor's prescription. In general, a doctor doesn't need a parent's permission to prescribe the pill to a teenager (but your state may have certain laws about this, so you would need to check). A teen would have to show the doctor that she understands the risks/benefits of this decision. Pill use has been proven to be both safe and effective in teens (as a side note, long-term options like IUDs and implants are also effective contraceptives for teens). However, starting the pill is a big decision, so teens may first want to discuss it with a parent or trusted adult.

10. The Pill Causes Different Types of Cancer

This is a common myth that has been shown over and over again, in research, to basically NOT be true. Generally speaking, using the pill does not increase your overall cancer risk. The pill actually has a protective effect against certain types of cancers.
  • Women who use the pill are 1/3 less likely to get ovarian or uterine cancer than those who don't. Protection against these cancers increases with each year of use and can last up to 30 years after ending pill use. Some experts advise that all women use the pill for at least 5 years, solely for ovarian cancer protection (especially women with strong family histories of ovarian cancer).
  • Pill use may reduce the risk of endometrial cancer by 50% with protective effects lasting up to 20 years. This is true of both short and long-term use.
  • There also appears to be evidence that pill use can result in an 18% reduction in the risk of developing colorectal cancer. This protective effect is greatest for recent pill users.
  • Recent research suggests that the pill has little if any effect on causing breast cancer and that taking estrogen before menopause doesn't predispose women to breast cancer.
  • Research does show that there may be an increased risk of cervical cancer if you use the pill, and that this risk increases with increased duration of use (meaning, the longer you use the pill, the higher your risk). On the flip side, the limited available data also suggests that cervical cancer risk may decrease once you stop using the pill. Cervical cancer can be discovered early and treated effectively. So if you are using the pill, make sure you have routine well-women check-ups to screen for cervical cancer. And since the HPV vaccine can help prevent cervical cancer, you can also ask your doctor about getting this injection.

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