12 myths about the birth control pill

There are a lot of out there for effective birth control and it can be confusing and create confusion when hearing anecdotal stories of others. Birth control methods include barrier methods (condom), birth control pills (Lolo, Alesse,TriCyclen etc), contraceptive vaginal rings (NuvaRing), transdermal contraceptives (Evra), and intrauterine systems or IUD’s (Mirena), to name just a few, each have their own individual pros and cons.

The most common among women is the birth control pill (BCP) and many of the myth busters here come from our conversations with our patients as we walk together through understanding their medications.

When used correctly, birth control pills are theoretically 99.7% effective. It’s pretty rare to get pregnant while properly (the key word is properly) taking birth control pills, yet many women feel a little voice of paranoia in the back of their head about the different things that could go wrong. 

Unfortunately, many women make mistakes or use their medication improperly thus increasing the failure rate as high as 9 in 100 women due to inconsistent or incorrect use. It is not the BCP that is ineffective it’s the lack of understanding by the user.

It is essential for women to take their birth control pills regularly, as inconsistent usage and/or missing pills can increase the risk of pregnancy. This is especially true for missing pills in the first or last week of a pack. Missing doses near the end or beginning of a cycle can extend the length of this period, increasing the risk of failure. Many birth control products include a medication-free period of one week each month to help keep track of the 7 days drug free. 

You may have heard that being overweight can make the birth control pill less effective. This may not apply to the birth control pill, however, women who weigh more than 90 kg and use the contraceptive patch rather than the pill may be at risk of an unplanned pregnancy.

Myth #1: Using any form of birth control means you’re protected against sexually transmitted infections (STI)

The only kinds of birth control that protect against both pregnancy and sexually transmitted infections are condoms. As barrier methods, they cut down on the two possible vectors of STI transmission: sexual fluids and skin-to-skin contact.

With that said, condoms can’t fully eliminate skin-to-skin contact, which means that even when you use them, you’re still at risk of getting certain STIs, such as herpes and human papillomavirus (HPV). This is why getting tested regularly so you know your STI status is a huge part of staying as safe as possible, even if you use condoms whenever you have sex.

Myth #2: Birth control causes weight gain

Despite many concerns regarding the association between birth control pills and weight gain, this myth is false. Contrary to popular belief, studies have shown that oral contraceptive pills do not cause weight gain. Some may argue that they experienced an increase in weight from taking the birth control pill, but this is likely due to other explanations, such as the normal growth of their bodies if they started it when they were young, or for other reasons such as increased appetite and bloating.

Myth #3: You don't need to be on birth control if you're breastfeeding

Breastfeeding exclusively (without supplementing with formula) can suppress the hormones from the pituitary gland that make you ovulate. So while there's certainly a dip in your fertility at this time, it's nowhere near foolproof.

Myth #4: You have to take the Pill at the same time every day

Despite what you may have heard, taking the Pill at the same time each day does not make it more effective. This common belief is only true if you're taking the mini-pill (a progestin-only birth control pill which must be taken at the same time every day), however the majority of women take the regular birth control pill, which contains a combination of estrogen and progestin. That said, you might want to stick to a strict schedule if you have trouble remembering to take it or if you're on a very low-dose form of the Pill, as you may experience some breakthrough bleeding.

Myth #5: It's unhealthy to use birth control to skip your period

It may seem sneaky and taboo to manipulate your monthly flow by taking two months of pills back to back—but the truth is, it's totally safe. If you are a good candidate to be on birth control in the first place—you're healthy, you don't have high blood pressure that's uncontrolled, you're not over 35 or a smoker—then you are indeed a candidate for fiddling around with your cycle under the supervision of your physician. Just be prepared for some breakthrough bleeding, which is more likely if you just started a new pill, if you're on a tri-phasic pill (like Ortho Tri-Cyclen), or if you delay it for more than a month or two. 

Myth #6: Birth control causes cancer

The answer to this question may surprise you: it’s both yes and no but do not fear.

For many, it may be surprising to find that birth control pills can decrease the risk of ovarian and endometrial cancers. These are cancers in the ovary and lining of the womb, respectively. On the other hand, prescription birth control pills can potentially cause a small increase in the risk of cervical cancer with long-term use. Fortunately, this risk may be reversible upon stopping. Additionally, there have been some concerns regarding the association between birth control pills and breast cancer, but this is still quite controversial and nothing yet is proven. This is why it is important to get your annual physical and PAP exams.

Myth #7: Birth control causes heart attacks

The risk of heart-related conditions in healthy females taking birth control pills is quite low. In fact, pregnancy puts women at a higher risk than the birth control pill itself.

There is, however, a small increase in the risk of what’s called a Venous Thrombo Embolism (VTE), which is the formation of a blood clot in the veins of the body. VTE’s generally form in deeper veins of the body – typically the leg, where they have the potential to break off and travel to the lungs, blocking the blood supply. The risk of these occurrences are very low, however, if you have a prior history of VTE’s, if you are a smoker or are simply concerned about them, it’s important to bring this up with your care provider before starting any birth control medication. On the other hand, if you experience any unusual swelling, redness, shortness of breath, dizziness, faintness, or coughing of blood while on these medications, seek care immediately.

Myth #8: The birth control pill causes infertility, and is unsafe during pregnancy.

Based on the current evidence, extended or continuous use of birth control pills has not raised any concerns with respect to infertility. Additionally, birth control pill exposure just before or during pregnancy is not associated with an increased risk of major birth defects. However, it is especially important to stop the birth control pill if you are pregnant.

MYTH #9: Birth control pills make it harder to get pregnant later.

If you know someone who forgot to take a pill or two and found themselves pregnant later that month, you’ll quickly realize this one is a myth. If you DID skip a pill, don't panic, call the pharmacy and talk to the pharmacist.  The truth is, the Pill will not sterilize you; instead, it raises your hormone levels to imitate pregnancy—and the body can’t get pregnant when it thinks it’s already pregnant. All reversible birth control methods (that is, everything other than actually “getting your tubes tied”) only protect against pregnancy while you are taking them, and you’ll be able to get pregnant pretty much as soon as you quit your birth control.

MYTH #10: Women over 35 shouldn’t take birth control pills.

This myth stems from an increased risk of heart disease, stroke, and cancer in older women, so doctors were hesitant about giving women over age 35 the extra dosage of estrogen. But the fear is usually unnecessary. A study published in the Journal of Reproductive Medicine demonstrated that women ages 35-50 who took oral contraceptives were not at a higher risk of these diseases; in fact, taking the Pill might even benefit some women, such as those with a family history of endometrial or ovarian cancer. One caveat: doctors still do not recommend birth control pills for women over 35 who smoke, have high blood pressure, or have a history of heart disease.

MYTH #11: Antibiotics make birth control pills less effective.

The antibiotics prescribed for common issues like acne, sore throat, UTIs, or vaginal infections will not mess up your hormonal birth control (meaning the Pill, patch, or ring). 

But, there’s a but. There are two antibiotics that can decrease the effectiveness of your daily birth control pill: rifampin and rifabutin. But physicians prescribe these antibiotics for more serious conditions like tuberculosis, so there’s a good chance most women will not need to take them.

That said, it’s always crucial to share with your pharmacist what medications you’re taking (including birth control and OTC - over the counter) to make sure none of them will have potentially negative or even dangerous interactions. Although commonly prescribed antibiotics are safe to use with your BCP, other kinds of medication can interfere, like drugs used to treat bipolar disorder. The pharmacist will counel you on what you need to do.

Myth #12: Your body needs a break from birth control. 

The only reason to take a vacation from your contraceptives is if you're hoping to get pregnant. Other than that, you can stay on your chosen method of birth control for as long as you want. The only exception: Depo-Provera, the birth control injection. Because it's been linked to a greater potential for bone mineral loss, it is recommended that women only take it continuously for two years. 

Overall, oral contraceptives are considered safe and effective, and again, proper and consistent use is key to ensuring that they work effectively. If you have any questions or concerns talk to one of our pharmacists.