Must Know Facts About the Pill

The pill is one of the two most commonly used birth control methods in the U.S. (the other is tubal ligation). In fact, four out of every five sexually active women have used the pill at some point in their lives.

Who Is Most Likely to Use the Pill?

  • Women in their teens and 20s
  • Women who have never been married
  • White women
  • Women who cohabit
  • Women who don’t have children
  • College graduates

So there’s no denying the popularity of the pill. But even if you take the pill every day, you may not know some of these important facts about the pill.

1

Your Chances of Getting Pregnant May be Higher Than You Realize

Birth Control Pills packet

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If you take the pill at the same time every day, the chance of becoming pregnant is 0.3%, meaning that of every 100 women who use the pill for a year, less than one will become pregnant. But, it can be very difficult to remember to take the pill every day let alone at the same time.

With less-than-perfect use—like taking a pill late one day or forgetting to take it altogether—the effectiveness drops to 91% (of every 100 women who do not use the pill perfectly for a year, nine will become pregnant).

There are some tricks to help you remember to take the pill at the same time each day. Make the pill a regular part of your morning routine (take it after brushing your teeth or when you’ve finished your morning coffee). You have a better chance of remembering to take the pill in the morning because, at night, you may be too tired and be more likely to forget. You can also try to use a birth control app or alarm to remind you to take your pill. Also, make sure to keep your pill pack in a place where you are guaranteed to see it every day, like next to your toothbrush or cell phone.

2

The Pill May Impact Your Sex Drive

Chinese couple relaxing on bed
Tanya Constantine / Getty Images

Some women who use the pill find that their sex drives go into high gear since they’re no longer concerned about getting pregnant. Other pill users report that the pill has the opposite effect—that it lowers libido and makes it harder to climax. One reason why the pill may lessen your sexual desire is because the pill can reduce your testosterone level, the hormone that fuels sex drive in all genders.

Even if you stop the pill to improve decreased libido, it could take several months to recover from a pill-related testosterone decline. In some cases, it may never recover because the levels of sex hormone binding globulin never fully return to their baseline levels, so levels of free testosterone remain low.

If you notice your libido is taking a nosedive, talk to your healthcare provider to see if you can switch to another pill brand that will hopefully allow your sexual desire to reignite. Remember, you have to give your body three months to adjust to the new pill brand before determining that your sex drive is still in the dumps.

Also, think if there is anything else going on in your life that may be affecting your libido, like stress or any medications you are taking. If all else fails, you may ultimately decide that the pill isn’t the right birth control for you.

3

The Pill Has Some Pretty Cool Health Benefits

Woman taking a pill

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When compared to women who have never used the pill, a 2021 study found that taking the pill for five or more years is linked to a more than 20% lower risk of developing ovarian cancer and an almost 30% lower risk of developing endometrial cancer. For women who took the pill for more than 15 years, the reduction in risk is close to 50% for both cancers. This protection is still seen in women who have stopped taking the pill. There is also an 18% drop in the risk of developing colorectal cancer among women who use the pill.

However, there is some increased risk of breast and cervical cancers associated with the pill, so be sure to talk to your healthcare provider about the benefits and risks.

Besides some cancer protection, the withdrawal bleed that you get when you use the pill is usually less painful than your normal period and doesn’t last as long. The pill can make your period more regular and it may even lead to a clearer complexion.

4

The More You Weigh, the Less Effective the Pill May Be

Bathroom scales on tiled floor
Image Source / Getty Images

If you are overweight or obese, your risk of getting pregnant while using the pill might be higher, though research results are inconsistent. Some research has found a large reduction in effectiveness for women who are overweight or obese (60–70% higher), while other studies found more modest effects, and yet others found little or no effect.

If you’re concerned that your weight might affect how well the pill works for you, talk to your healthcare provider. A higher-dose pill might be called for, or another form of hormonal contraception, such as an implant.

5

You May Have to Try Many Pill Brands Before Finding the Right One

birth control pill packs

TEK IMAGE / Getty Images

The pill is definitely not one size fits all. There are so many kinds and formulations available, and each may affect your body in a different way. Here’s a crash course on pill types:

  • Combination Pills: these have a formulation of estrogen and progestin. Monophasic pills have a fixed dose of these hormones in every pill. In biphasic and triphasic pills, the ratios and/or amount of these hormones change throughout each pill pack.
  • Progestin-Only Pills (also called the mini pill): these pills do not contain any estrogen.

Even among these types of pills, each has a different estrogen dose and type (and dose) of progestin. This means that each brand can affect you differently. This is why it’s very important that you talk to your healthcare provider if you are dealing with bothersome side effects from the pill.

Certain side effects have to do with the amount of estrogen or progestin in the pill, so switching to a different formulation may solve the problem. Keep in mind that you need to be patient. It takes about three months for your body to adjust to the hormones in the pill, so you’ll need to let at least this amount of time go by before you make the decision to switch again.

In July 2023, the Food and Drug Administration (FDA) approved Opill (norgestrel), a progestin-only oral contraceptive, to be sold OTC. Opill is the first and only birth control pill available without a prescription. Before starting a birth control method, it's a good idea to speak with your healthcare provider, even if your method of choice doesn't require a prescription.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  4. Zimmerman Y, Eijkemans MJ, Coelingh Bennink HJ, Blankenstein MA, Fauser BC. The effect of combined oral contraception on testosterone levels in healthy women: a systematic review and meta-analysisHum Reprod Update. 2014;20(1):76-105. doi:10.1093/humupd/dmt038

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  7. National Cancer Institute. Oral contraceptives and cancer risk.

  8. Mendoza N, Lobo P, Lertxundi R, et al. Extended regimens of combined hormonal contraception to reduce symptoms related to withdrawal bleeding and the hormone-free interval: A systematic review of randomised and observational studies. Eur J Contracept Reprod Health Care. 2014;19(5):321-339. doi:10.3109/13625187.2014.927423

  9. Trivedi MK, Shinkai K, Murase JE. A review of hormone-based therapies to treat adult acne vulgaris in women. Int J Womens Dermatol. 2017;3(1):44-52. doi:10.1016/j.ijwd.2017.02.018

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Dawn Stacey

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.