Top docs share the most common misconceptions about the pill, hormones, and fertility. This is the real deal
We may know a thing or two (or three) about sex, but some myths continue to persist, even well into adulthood. Our parents’ generation tried to inform us based on their experiences, not realizing that a whole lot has changed—both in terms of scientific research and the methods of contraception available. And between alarming news reports, viral blogs, Facebook feeds, and the rumor mill of friends and acquaintances, it’s no wonder it’s become difficult to separate fact from fiction.
“What’s more, sex and sexuality are still something many people aren’t talking about, making it easy for misinformation to spread,” says Vanessa Cullins, M.D., an ob-gyn and vice president for external medical affairs at Planned Parenthood. To clear up the confusion once and for all, we asked top docs about the most common misconceptions they see in their practices. This is the real deal.
Some research suggests women using oral contraceptives with high-dose estrogen have a slightly higher risk of breast cancer. But taking pills with a low dose of estrogen (the kind most women take) was not associated with increased risk. “High-dose pills are extremely uncommon today; most pills we prescribe...contain very low doses of estrogen,” says Colleen Krajewski, M.D., a gynecologist on the board of The National Campaign to Prevent Teen and Unplanned Pregnancy. What’s more, breast cancer is rare among young women (the demographic most likely to be on the pill), and additional research has shown that the risk drops as soon as you stop taking the pill and returns to normal after 10 years—just when your risk for breast cancer would be highest.
But here’s the real kicker: “Birth-control pills actually protect against cancers, cutting your risk for ovarian cancer in half after five years of use,” says Krajewski. Women who have taken oral contraceptives have slightly lower rates of colon cancer, and the use of birth-control pills has prevented 200,000 cases of endometrial cancer in the past 10 years, according to a review of 36 studies just published in The Lancet. Bottom line: Birth control is actually most likely to reduce your risk of cancer.
“I hear this one all the time. 'Hormones are bad, birth control delivers high doses of hormones, and I don’t want all that in my body.' But it’s just not true,” says Dr. Krajewski. “In a natural menstrual cycle (one when you’re not on birth control), your body experiences high levels of estrogen and progesterone and extremely low levels. Instead of these big ups and downs throughout the month, combined birth control methods—those containing estrogen and progestin—keep you on a more straight line, delivering a continuous, average amount of hormones. This is the reason many women actually experience fewer symptoms of PMS while on birth control.”
What’s more, there’s little need to worry that birth control hormones will somehow build up in your body. “The hormones in birth control only last a day—that’s why you need a daily dose,” says Anne Burke M.D., associate professor of gynecology and obstetrics at Johns Hopkins Medicine in Baltimore.
However, some still wonder whether it’s “unnatural” or harmful to stop your body from ovulating for an extended period of time. “The whole time women are pregnant or breastfeeding, they don’t ovulate, and no one is worried about that,” says Krajewski. “Our bodies don’t have to ovulate every month, and your body won’t forget how to do it if you use birth control for several years. In fact, diseases like ovarian cancer are directly related to the number of times you’ve ovulated, which is why birth control can lower your risk for ovarian and endometrial cancer.”
The rare risks—such as blood clotting and stroke—associated with combination progestin and estrogen birth-control pills are actually highest when you first begin taking birth control, so stopping and starting is not safer. (Plus, it will only put you at risk for an unplanned pregnancy.) If you’re still not comfortable taking hormones or don’t like the way the hormones make you feel, consult your doctor. Many women feel better on progestin-only methods or hormone-free alternatives such as the copper IUD.
Scary warnings in sex-ed classes can leave you feeling like you’re at constant risk of getting pregnant, but conceiving is more complicated than that. “There are only [about six days] each month when you can actually get pregnant,” says Cullins. “This window varies depending on the length of your cycle, making it difficult to determine exactly when ovulation is occurring. This is why it’s so important to use contraception and only stop when you want to become pregnant.” If the test is negative after you have unplanned, unprotected sex, count yourself lucky, not infertile. “Some people get pregnant immediately, but for others, it can take time,” says Cullins. “When you do want to have a baby, you should expect to try for at least 12 months.”