Busting Common Myths About Birth Control 

When it comes to birth control, misinformation and myths abound, which can make it difficult for individuals to make informed decisions about their reproductive health. Despite the widespread availability of accurate information, many misconceptions persist, fueled by outdated beliefs, cultural taboos, and sometimes, plain old-fashioned misunderstandings. Whether it’s about the safety of long-term contraceptive use, the impact on fertility, or the effectiveness of different methods, these myths can lead to confusion and anxiety.

In this blog post, we aim to dispel some of the most common myths surrounding birth control. By providing clear, evidence-based information, we hope to empower you with the knowledge needed to make confident decisions about your contraceptive options. Let’s dive in and debunk these myths once and for all, ensuring you have the facts to take control of your reproductive health.

Myth 1: Birth Control Causes Future Infertility

One of the most pervasive myths about birth control is that it causes infertility. This misconception has caused significant anxiety among women who fear that using contraceptives, particularly hormonal methods like birth control pills, will negatively impact their ability to conceive in the future. The myth likely stems from misunderstandings about how contraceptives work and the body’s natural fertility cycles.

Numerous studies have been conducted to investigate the long-term effects of various contraceptive methods on fertility. The overwhelming consensus among medical professionals and researchers is that birth control does not cause infertility – a systematic review and meta-analysis [1] showed that contraceptive use regardless of duration and type did not have any negative impact on ability to conceive following discontinuation, with no significant delayed fertility either. Here are some key findings:

• Hormonal contraceptives and patches/vaginal rings: The misconceptions surrounding oral contraceptive pills, in particular, are rampant partly due to it being a better-known contraceptive option amongst women. In reality, research has shown that hormonal contraceptives, including birth control pills, patches, and injections, do not have a lasting impact on fertility. A comprehensive survey of reported data [2] has also indicated that the return of fertility in women who stop the use of contraceptive pills in order to conceive is comparable to that observed with other contraceptive methods. The patches/vaginal rings work similarly to the contraceptive pills. A review [3] found that women who discontinued hormonal contraceptives were able to conceive at rates comparable to those who had never used these methods. The average time to conception was similar, with most women conceiving within 12 months of stopping the pill.

• Intrauterine Devices (IUDs) and implants: both hormonal and non-hormonal IUDs are popular long-acting reversible contraceptive options. In fact, the proportion of fertility return among IUD users was shown to be 100% in this study [4], with another study [5] showing that fertility of women is not impaired by the use of IUDs as a spacing method. Even in those experiencing a slight short-term delay in return of fertility, the time interval from IUD discontinuation to pregnancy has been reported [6] to be 3-5 months [7] with no long-term delay.
• Injectable contraceptives: injectable contraceptives like Depo-Provera have been scrutinized for their potential impact on fertility. While it may take longer for fertility to return after discontinuing Depo-Provera (up to 9 months), this delay is usually temporary [8]. There is also evidence that prolonged use of Depo-Provera does not increase the delay before conceiving successfully. 
• Contraceptive Implants: like other hormonal methods, contraceptive implants do not have a long-term effect on fertility. Fertility generally resumes quickly once these methods are discontinued – the nexplanon manufacturer recommends starting another birth control right away after removal of the implant if one does not wish to get pregnant. 

Myth 2: Birth Control Pills Cause Weight Gain

The belief that birth control pills cause significant weight gain is widespread and has been a concern for many women considering hormonal contraception. This myth likely originates from early formulations of the pill, which contained higher doses of hormones that could lead to water retention and increased appetite.

Modern birth control pills contain much lower doses of hormones, and extensive research has been conducted to determine their effects on weight. Multiple Cochrane reviews [9] have ultimately shown no causal association between combination contraception i.e. contraceptive pills/ patches etc and weight gain.  

While birth control pills are not directly linked to weight gain, maintaining a healthy lifestyle is essential for overall well-being. Here are some tips to help manage weight while on birth control:

• Balanced diet: focus on a diet rich in fruits, vegetables, whole grains, and lean proteins. Avoid processed foods and sugary snacks that can contribute to weight gain.
• Regular exercise: incorporate both aerobic exercises, like walking or cycling, and strength training into your routine. Aim for at least 150 minutes of moderate exercise per week.
• Stay hydrated: drinking plenty of water helps reduce fluid retention and supports overall health.
• Monitor portions: be mindful of portion sizes to avoid overeating. Eating smaller, more frequent meals can help regulate appetite.
• Stress management: practice stress-reducing activities such as yoga, meditation, or deep-breathing exercises, as stress can sometimes lead to overeating.

Myth 3: Birth Control is Only for Women Who Have Had Children

Another common myth is that birth control is only appropriate for women who have already had children. This misconception might stem from historical practices or cultural beliefs that suggest younger women or those without children should not be using contraceptives, or should not be sexually active until/unless she is ready for child-bearing. 

In reality, birth control is suitable for all women, regardless of whether they have had children. The purpose of contraception is to allow women to plan and space their pregnancies as they see fit, which is relevant to women at all stages of life. Beyond just providing contraception, various birth control methods can help manage menstrual issues such as irregularities, dysmenorrhea, heavy flow that arise from a range of gynaecological conditions such as polycystic ovary syndrome (PCOS), endometriosis, adenomyosis, uterine fibroids, reduce the risk of certain cancers. The World Health Organization (WHO) also supports the use of contraceptives for all women of reproductive age. Healthcare providers recommend contraceptive methods based on an individual’s health, lifestyle, and reproductive goals, rather than their parental status.

Examples of Different Methods Suitable for Various Life Stages

• Young adults and adolescents: for younger women [10] or those just starting to use contraception, options like birth control pills, patches, vaginal rings and condoms can be effective and easily reversible. Long-acting reversible contraceptives (LARCs), such as IUDs and implants, are also excellent choices due to their effectiveness and convenience.
• Women in their 20s and 30s: during this life stage, many women may be focused on career development or other personal goals. Long active reversible contraception aka LARCs, including IUDs and contraceptive implants, provide long-term protection without the need for daily attention. For women who prefer less invasive methods, birth control pills, patches, vaginal rings, condoms  remain popular choices as well.
• Perimenopausal women: for women approaching menopause, contraception can still be necessary as fertility declines but does not disappear entirely. Low-dose hormonal options like the mini-pill or hormonal IUDs can help manage perimenopausal symptoms while providing reliable contraception. Non-hormonal methods like the copper IUD and condoms are also effective for those who prefer to avoid hormones. 

By understanding that birth control is appropriate for women at any stage of life, individuals can make informed choices that best suit their health and lifestyle needs. Dispelling these myths helps ensure that all women have access to the contraceptive options that work best for them. 

Myth 4: Natural Methods Are Just as Effective as Modern Contraceptives

The idea that natural methods of contraception, such as the rhythm method or withdrawal, are just as effective as modern contraceptives is a common misconception. This myth often persists due to a lack of understanding about how these methods work and their inherent limitations.

Effectiveness rates for contraceptive methods are usually measured in terms of typical use, which accounts for human error, and perfect use, which assumes the method is used exactly as intended. Natural methods generally have much lower effectiveness rates compared to modern contraceptives – this is because viable sperm can be found in anywhere between 16.7 to 41% [11] of pre-ejaculatory fluid: 

• Natural Methods:
  • Rhythm method: typical use effectiveness is around 76% [12], meaning 24 out of 100 women using this method will become pregnant within a year.
  • Withdrawal: typical use effectiveness is approximately 78% [13], with 22 out of 100 women becoming pregnant within a year.

• Modern Contraceptives:
  • Birth control pills: typical use effectiveness is about 91% [14], with 9 out of 100 women becoming pregnant within a year. This statistic is typically due to imperfect use of the pill i.e. taking the pill late or forgetting to take the pill, as perfect use is actually associated with up to 99% of effectiveness in preventing an unplanned pregnancy 
  • Intrauterine Devices (IUDs): typical use effectiveness is over 99% [15], with fewer than 1 out of 100 women becoming pregnant within a year. 
  • Implants: also have an effectiveness rate of over 99%  [16] with typical use.
  • The reason why both IUDs and contraceptive implants have higher effectiveness rate is because these options are considered “user-independent” i.e. they are not dependent on the user to remember to take/use something on a regular basis. 

While natural methods can still be somewhat effective when used perfectly, they require rigorous tracking of fertility signals and strict adherence to guidelines; this may be further confounded if one does not have perfectly regular menstrual cycles or lead a busy lifestyle. In contrast, modern contraceptives like IUDs, implants, and birth control pills offer higher reliability and ease of use, which makes them a preferred choice for many women.

Myth 5: Long-Term Use of Birth Control Pills is Dangerous

The belief that long-term use of birth control pills is inherently dangerous stems from concerns about potential health risks, such as cancer or cardiovascular disease, associated with extended hormone exposure. This myth often causes unnecessary anxiety among women who rely on the pill for contraception.

Extensive research has shown that long-term use of birth control pills is generally safe for most women. Key findings include:

• Cancer risk: studies indicate that while there may be a slight increase in the risk of breast [17] and cervical cancer [18], the pill significantly reduces [19] the risk of ovarian, endometrial, and colorectal cancers. The American Cancer Society states that the overall benefits of oral contraceptives outweigh the risks for most women.
• Cardiovascular health: while there is a slightly increased risk [20] of blood clots, heart attack, and stroke, these risks are primarily associated with women who smoke, are over 35, or have certain health conditions. For most women, the cardiovascular risks are minimal. In fact,  the risk of deep vein thrombosis (DVT) in users of combined contraceptives is still smaller than the risk [21] in pregnancy and appears to decline over time. It is hence important to discuss your individualized risk with your healthcare provider to understand which contraceptive method suits you the best.

Use of birth control pills offers several health benefits beyond contraception:

• Menstrual regulation: birth control pills can help regulate irregular menstrual cycles [22] and reduce menstrual cramps and heavy bleeding.
• Acne and Hirsutism: the pill [23] can improve acne and reduce unwanted hair growth in women with polycystic ovary syndrome (PCOS).
• Endometriosis: birth control pills can alleviate the pain [24] and other symptoms associated with endometriosis.

These benefits make long-term use of birth control pills a valuable option for many women, as they provide both contraceptive and non-contraceptive health benefits.

Myth 6: Birth Control Protects Against STIs

A common misconception is that all forms of birth control provide protection against sexually transmitted infections (STIs). This myth can lead to a false sense of security and increased risk of STI transmission.

Most contraceptive methods are designed to prevent pregnancy but do not offer protection against STIs. 

• Hormonal Contraceptives (Pills, Patches, IUDs, Implants): these methods are effective at preventing pregnancy but do not protect against STIs.
• Barrier Methods (Condoms): condoms are unique among contraceptives in that they provide dual protection—preventing both pregnancy and the transmission of STIs [25] when used correctly. To protect against STIs, it is crucial to use condoms in conjunction with other contraceptive methods. Consistent and correct use of condoms significantly reduces the risk of transmitting infections such as HIV, chlamydia, and gonorrhea. For comprehensive sexual health protection, combining condoms with another form of contraception is often recommended  – using condoms will not reduce the efficacy of the other form of contraception either.

Myth 7: You Don’t Need Birth Control After a Certain Age

Some believe that birth control is unnecessary for women over a certain age, particularly those nearing menopause. This misconception can lead to unintended pregnancies in perimenopausal women who may still be fertile.

Fertility declines with age, but it does not disappear entirely until menopause is reached, which is defined as 12 consecutive months without a menstrual period. During perimenopause, the years leading up to menopause, women can still ovulate and conceive, which makes contraception necessary to prevent unintended pregnancies.

Several contraceptive options are suitable for older women, considering their unique health needs:

• IUDs and contraceptive implants: both hormonal and copper IUDs offer long-term, reliable contraception without the need for daily management. Hormonal IUDs and contraceptive implants can also reduce heavy bleeding and cramps. Depending on the woman’s age and the type of LARC chosen can serve as a reliable birth control method until she attains menopause.
• Barrier methods: condoms and diaphragms remain effective options and provide added STI protection.
• Sterilisation: For women who are certain they do not want more children, permanent methods like tubal ligation can be considered. Although there are rare instances of successful reversal of sterilisation, it is important to know that sterilisation is generally considered permanent and irreversible; as such, one should be very sure of their future fertility desires before arriving at this option.  It is also worthwhile to note that male ligation (i.e. vasectomy) is typically less invasive and more successful than female ligation (i.e. tubal ligation), although both male/female sterilisation remain the most effective contraceptive options. 

By understanding that fertility does not cease immediately at a certain age and recognising the need for continued contraception during perimenopause, women can better manage their reproductive health and avoid unintended pregnancies. 

Conclusion 

Myths surrounding birth control methods can create significant barriers to making informed decisions about reproductive health. These misconceptions, whether about the safety, effectiveness, or suitability of various contraceptive options, often stem from outdated information and cultural misunderstandings. Such myths can lead to unnecessary fear and confusion, preventing individuals from using the most effective and appropriate methods for their needs.

It is essential to be well-informed about the wide range of birth control methods available today. Modern contraceptives offer numerous options tailored to different lifestyles, health conditions, and reproductive goals. Understanding the true effectiveness, benefits, and potential side effects of each method allows individuals to choose the best option for their unique situation.

It is also important to understand that birth control is a shared responsibility between all parties involved. While many current contraceptive methods primarily fall on the female partner, it’s important for the male partner to also take an active role in the process. This collaborative approach ensures that both partners contribute to effective and responsible family planning.

Consulting a gynecologist or healthcare provider is a crucial step in this process. These professionals can provide accurate, up-to-date information and personalised recommendations based on a thorough understanding of your medical history and reproductive goals. Consult your gynecologist to make sure you select a birth control method that is both effective and aligned with your health needs.

References 

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2. Barnhart, Kurt T., and Courtney A. Schreiber. “Return to Fertility Following Discontinuation of Oral Contraceptives.” Fertility and Sterility, vol. 91, no. 3, Mar. 2009, pp. 659–63. PubMed, https://doi.org/10.1016/j.fertnstert.2009.01.003. 
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