Life & Love

The benefits of adopting a trusted birth control system would fill up a nice-sized laundry list, but, unfortunately, so would the myths surrounding it. We asked OB-GYNs Dr. Michelle Moniz and Dr. Alyssa Dweck to debunk the most common ones.

“You gain weight when you’re on the pill.”

There’s nothing wrong with wondering how a new medication might affect your body, but fret not. Both docs were quick to explain there’s no real evidence that suggests birth control alone causes weight gain. Anecdotally, they’ve had patients report some weight fluctuations, but they say outside factors like lifestyle changes or increased stress are more often the culprit.

Dr. Dweck notes that many young women start the pill shortly after puberty or when they go off to college, a time in your life when you may be more likely to gain weight regardless. There’s one notable exception, she explains, which is the Depo-Provera shot. Though most women gain only a few pounds using it, some may gain more.

“If I’m on birth control, I don’t have to worry about STIs.”

Hopefully this myth is corrected ASAP by your doctor before you start your birth control, because it’s an important one. Only barrier methods of contraception like condoms and dental dams are effective at lowering risks of STI transmission. Dr. Dweck notes this is true whether you’re sleeping with men or women, so plan ahead.

“Birth control pills don’t really ‘work’ for me.”

Don’t give up just yet! Some people may experience side effects like breakthrough bleeding, for example, on one type of pill and fall totally in love with another. That’s because birth control pills are not necessarily one size fits all, and there are different combinations.

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“But, seriously, no question is stupid.”

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Pills are typically made up of both estrogen and progestin or are progestin-only; and even within those two major types there are variations in the formula, Dr. Moniz explains. “Generally speaking, there’s often some benefit to trying a pill from a different family if you don’t like the first pill that you tried and you still want to use that method,” she says. Your doctor should be more than happy to engage in a little trial and error until you find your perfect pill.

“You still need to have a ‘fake’ period.”

The verdict from both experts: It’s not medically necessary to have a period once a month. While there’s some debate over why the break in pills that leads to bleeding exists—one of the creators apparently wanted the Pope to approve, and others say it’s to help women know they’re not pregnant—one thing is for sure: You don’t need it.

If you want some of the science, Dr. Dweck breaks it down: “When you’re on the combination birth control pill, the progesterone portion of it protects your uterine lining from an overgrowth of tissue, so you actually really don’t need to shed it unless you want to.” So that monthly bleeding isn’t technically a period at all.

One risk of skipping the placebo week, or “stacking” your pills, as Dr. Moniz explains, is running out of your prescription too quickly. However, she notes that doctors can often prescribe around that issue if you bring it up at your appointment, or put you on a pill with fewer periods a year.

“Being on it long-term will affect my fertility later in life.”

If this is a concern for you, let Dr. Moniz put you at ease. “You know why we have to take a birth control pill every day? It’s because it doesn’t have a long-acting effect. It’s metabolized or broken down by your body, and that’s why you have to redose it again tomorrow. And similarly, the IUD or the implant stops working immediately when they are removed.”

If you’ve heard stories about women struggling to conceive after being on birth control, there could be other factors at play. For one, age could be the issue. “If you started the pill at 20 and fifteen years later at 35 you’re trying to get pregnant and you’re having some difficulties, it really may just be that you’ve aged rather than the actual use of the pill,” Dr. Dweck notes.

Similarly, she adds, if you went on the pill because of irregular periods that could have been caused by ovulation issues, your body returns to that baseline when you go off it. Getting pregnant could be difficult for that reason.

“If you don’t take your pill at the exact same time every day you’ll get pregnant.”

Consistent use is key when it comes to oral contraceptives, but you really don’t need that alarm clock set down to the minute (unless you’re super forgetful). Dr. Moniz estimates you have a daily window of a few hours for the combined pill, and one to two hours on progestin-only pill. On the combined pill you can even skip a day by mistake, so long as you take it the next day when you remember, and still be protected, according to Dr. Moniz.

It’s not an excuse to be lazy with your birth control, but it is a good reminder not to panic if you slip up a little. If you miss more than day and you’re sexually active, Dr. Moniz recommends talking to your doctor to discuss your options.

“Birth control is too expensive.”

While there’s no doubt navigating the insurance powers that be can be complicated, Dr. Moniz points out that even with the recent challenges to the Affordable Care Act, most insurance companies consider it cost effective to cover birth control, as pregnancies are even more expensive healthcare-wise. So, you’ll likely still be covered for low or no-cost birth control.

If you don’t have insurance, organizations like Planned Parenthood may work with you on a sliding scale based on your income. There are also plenty of new start ups like Nurx, which will deliver pills to your door, and Hers, which will deliver pills for $30 a month, regardless of your insurance situation.

“Getting an IUD H-U-R-T-S.”

Dr. Dweck is quick to explain that while IUD insertion is not exactly a comfortable experience, it’s not necessarily the traumatic ordeal you may have heard about. She uses a numbing cream for insertions with her patients, and if you discuss your concerns with your doctor in advance, they may be able to prescribe a one-time dose of a stronger pain killer or an anti-anxiety med. The bottom line: Don’t let the fear of pain keep you from getting the protection you want.

“It only really matters if you’re trying to avoid getting pregnant.”

There are so many medical benefits to birth control that it’s hard to list them all, but we’ll give it a shot in the name of myth-busting: lighter periods, more regular periods, less severe cramping, clearer skin, treatment for endometriosis, and even potential treatment for some pre-cancers. All worthy factors to consider even if preventing pregnancy isn’t top of mind.

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