Modern birth control is amazing. It helps women take control of their reproduction, plan ideal periods, and manage pesky, painful symptoms.
And with so many options – dozens of pills, five different IUDs, a super-effective arm implant, and more – it’s easier than ever for most women to find contraception that works for them.
Unfortunately, birth control is still dogged by myths and misinformation. That’s why we spoke with two gynecologists and asked them to set the record straight on common contraceptive untruths. Here’s what they had to say.
MYTH: You can’t get pregnant if you’re on birth control.
“Most people think that these methods are infallible,” gynecologist Nerys Benfield, director of the division of family planning at the Montefiore Health System, told INSIDER. “None of them are. Not even sterilization is 100 percent effective.”
It’s true: Female sterilization, or “getting your tubes tied,” is more than 99 percent effective but still not perfect, according to data from the Centers for Disease Control and Prevention (CDC). Remember that pregnancy is still possible no matter what type of contraception you use.
MYTH: The morning after pill is 100 percent effective.
The morning after pill is a type of emergency contraception that works by delaying ovulation or the release of an egg from your ovary. If there’s no egg to be fertilized by sperm, you won’t get pregnant.
But, just like other forms of contraception, it’s not perfect.
“It only works by delaying your ovulation, so if you already ovulated, taking [emergency contraception] is not going to help you at all,” Benfield said. (Not sure when you’re ovulating? A period tracker app can help.)
A more effective type of emergency contraception is the copper IUD, sold under the brand name ParaGard. If it’s inserted within five days of unprotected sex, it prevents 99.9 percent of pregnancies – and you can simply leave it in your uterus for 10 more years of pregnancy prevention.
Both the IUD and the morning-after pill have their pros and cons, though. Planned Parenthood has a simple guide that will help you make the right choice.
MYTH: Hormonal birth control is toxic and unnatural.
Some extreme “wellness” bloggers publish screeds against hormonal birth control, claiming that it’s unnatural, toxic, and unequivocally dangerous for your body. But it’s not that black and white.
Yes, all types of hormonal birth control have real risks worth discussing with your gynecologist. But for a lot of women, the benefits of hormonal birth control easily outweigh those risks, according to gynecologist Alyssa Dweck, author of The Complete A to Z for your V.
Someone with endometriosis, for example, might have crippling menstrual pain without the use of hormonal birth control.
“While I appreciate that there are a lot of people who don’t want to take hormones, there are going to be people who will truly suffer without them,” Dweck told INSIDER. “And I think that we really have to take everybody on a case by case basis.”
If you really don’t want to take extra hormones but still want effective birth control, there’s one solution: ParaGard, the copper IUD. The only active ingredient is copper, it’s more than 99 percent effective, and it gives you 10 years of protection (or more).
MYTH: You need to take the pill at the exact same time every day.
The truth depends on which type of pill you take.
If you take the progestin-only pill – sometimes called the mini-pill – you really do need to take it at the same time every day, since its effects start to wear off after about 26 hours, Benfield said. If you’re late by three hours or more, you need to use backup birth control, like a condom, for the next two days.
But if you take the combined pill, which contains progestin and estrogen, Benfield said there’s more wiggle room. That’s because this pill prevents ovulation, which doesn’t work like a light switch.
It takes time for your ovary to prepare and release an egg, so if you’re a few hours late to take the pill, you’re still in the clear. (Missed pills, especially during the first week of the pack, are a different story.)
Of course, some doctors still encourage taking both types of the pill at the same time every day, simply because it helps you form a habit. Just know that you don’t need to panic if you’re a few hours late to take a combined pill.
MYTH: It’s not safe to skip periods using birth control.
Some women eliminate their periods by skipping the last week of placebo pills and jumping straight into a new pack of birth control pills. Others do it by leaving their hormonal ring in place for four weeks instead of three.
And some forms of hormonal birth control, like the IUD and the implant, can make your period disappear completely. All of this is totally safe.
“People think, ‘If I’m not bleeding, it’s because all this stuff that’s supposed to be coming out is actually staying inside,'” Benfield said. But skipping periods doesn’t mean that you have a buildup of blood in your uterus.
“What the hormone does is it keeps the uterine lining thin. It keeps the uterus empty and clean, so there’s nothing that needs to come out,” Benfield added.
If you like the assurance of monthly periods, that’s great. But if you’d rather not deal with them, that’s great, too. Skipping periods can even benefit your health: Benfield said reducing the frequency of your menstrual cycles lowers your risk of endometrial cancer.
MYTH: IUDs cause abortions.
IUDs prevent an egg from getting fertilized and implanting in the uterus – they don’t cause an “abortion” of a fertilized egg.
“With the copper IUD, the way I describe it in layman’s terms is that copper kills sperm,” Benfield said. “So even though you’re still ovulating and the sperm is still getting into the uterus, when they pass by that wall of copper ions, they become dysfunctional.”
Hormonal IUDs like Mirena and Skyla work a bit differently, but the outcome is the same.
“One of the major effects of the hormones is to give you this thick cervical mucus which forms this aggressive barrier to sperm,” Benfield added. “So the sperm are not able to get into the uterus in a consistent way. I call it the cervical blockade.”
MYTH: The morning after pill causes an abortion.
Yes, there is a pill that induces abortion, but the morning after pill is something entirely different.
“I have a lot of patients who, for reasons of religion or personal beliefs, are afraid to take the morning after pill because they think they’re going to have an abortion,” Dweck said.
“[Emergency contraception] really is going to just prevent pregnancy but not cause an abortion.”
That’s because – as noted earlier – it targets your ovaries, preventing them from releasing an egg in the first place. It doesn’t “abort” fertilized eggs.
MYTH: The pill can mess with your fertility.
“I think the biggest myth with birth control pills is that they’re somehow going to mess with your fertility,” Dweck said. “The pill in and of itself does not influence fertility.”
But it might seem that way. Dweck explained that sometimes the reasons that a woman starts taking the pill – like erratic periods or hormone imbalance – are the real reason for fertility problems. Those issues might crop up again as soon as a woman gets off the pill and starts trying to get pregnant.
It’s also important to remember that female fertility declines with age, no matter what birth control you use.
“Say somebody’s on the pill for 20 years and now suddenly they find themselves at the age of 35. The time that passes is going to influence fertility, rather than being on the pill all that time,” Dweck said.
MYTH: IUDs can mess with your fertility.
IUDs have a bad reputation for causing infertility. That’s partly thanks to the Dalkon Shield, an IUD used back in the 1970s that increased the risk of pelvic inflammatory disease – a serious infection that can lead to infertility.
But today’s IUDs are made of different materials and are far safer, both Dweck and Benfield confirmed.
“The IUDs we have now have been vigorously researched and tested and evaluated,” Benfield said. “We have great information and research to show that not only do they not increase the risk of infection, they actually decrease your risk of infection.”
MYTH: All women gain weight on the pill.
“The usual rule of thumb is that about a third of women on birth control pills will gain weight, a third of women will probably stay the same, and there are even a group of women who may lose weight,” Dweck said.
In short: We can’t really make blanket statements about the pill and weight gain.
Even if it seems like the pill is the culprit, Dweck noted that there might be totally unrelated factors at play. For example, some women go on the pill in their early teens and gain weight simply because their bodies are growing.
Others start the pill right before college and gain weight because of lifestyle changes, like increased alcohol consumption.
One final note: “If you don’t want to gain weight, the one birth control you probably should stay away from is the shot,” Dweck said. “I would say the rule rather than the exception is that people gain a couple of pounds from that.”