By Emma Stessman
Oral contraceptives changed history for women, but many people are still confused about how taking them can affect a woman’s body and health.
But with lots of recent attention on the importance of balanced hormones, using synthetic hormones to create an artificial menstrual cycle may feel unsettling for some. For example, while the pill is an effective tool for treating acne, PCOS, endometriosis, and PMS, many functional medicine doctors and hormonal wellness experts say that it’s essentially putting a band-aid on those issues when you should be concerned with getting at the root of what’s causing them, and that long-term use may impact overall health in bigger ways.
Those arguments are worth a discussion of their own (more on that soon!), but in the meantime, it’s worth getting some basic questions about birth control pills answered. Here, top OB/GYNs answer five of the most common questions about the pill from a medical standpoint, whether you’ve been on it for years or are debating making it your new birth control method.
5 Common Questions About Birth Control Pills
1. Should you take a break from the pill?
It’s a pretty common myth that long-term contraceptive use should come with a break period (pun intended), says Jennifer Butt, MD, a gynecologist and founder of Upper East Side Obstetrics & Gynecology. “If you need to be on OCP [oral contraceptive pills] whether to regulate your cycles, control your flow or pain, or for contraceptive purposes, you should stay on it,” she says. “If you’re not looking to get pregnant and are sexually active, there’s no reason to stop birth control.” If you are seriously concerned about how it may affect your hormones, be open with your doctor and talk to her about alternative options.
2. Do you need to take the sugar pills?
Otherwise known as the placebo pills, the bottom layer of your pack simply serves as a place holder so you remember when to start a new one, says Felice Gersh, MD, a board-certified OB/GYN. In fact, according to Vice, the man who helped develop oral contraception added them simply because it seemed more “natural” for a woman to have a period. Scientifically though, there’s no reason to take the placebos and you can immediately move onto the next pack of active pills. If you do notice some bleeding while you’re on the active pills, it’s totally normal. Continuous birth control can result in some light spotting, otherwise known as breakthrough bleeding.
3. Will long-term contraceptive use affect your fertility?
If you start taking the pill when you’re 17 and go off it when you’re 35, it stands to reason that you’ll be less fertile at the older age. But the oral contraceptive is not to blame. “OCPs and contraception, in general, don’t affect your fertility,” Dr. Butt says, and science supports that. A study tracking nearly 60,000 birth control pill users found that a woman’s odds of getting pregnant after stopping birth control are equal to those of someone who has never been on the pill.
4. Are there side effects?
Unfortunately, yes. Side effects are pretty common in those who take birth control pills, Dr. Gersh says. Spotting, cramping, headaches, and nausea are all normal side effects for those who are just starting the pill, but they should go away within the first two to three months. Taking the pill also significantly increases the risk of developing a blood clot, but that risk is still very low. Overall, the pill is considered safe.
5. How do birth control pills impact your risk of cancer?
The answer here isn’t so simple. Studies have shown that women who take the pill have a slightly higher risk (doctors often emphasize how small the increase is) of breast cancer and an elevated risk of ovarian cancer, but both return to normal ranges after stopping birth control. On the other hand, oral contraceptive use is associated with a lower risk of endometrial, colorectal, and ovarian cancer. “Every patient is different, including their risk for the above cancers,” Dr. Butt says. “I would encourage women to speak to their doctor about what is best based on their own medical and family history.” (For the small percentage of women who have BRCA mutations, for example, the risks are different.)
Okay now that you’ve had your primer on birth control, maybe it’s time to read up on healthy habits that boost your sex life?