Debunking 8 common birth control myths

From fear of putting on weight to infertility, here is the truth about some of the most common misconceptions around contraceptives.

According to the Centers for Disease Control and Prevention (CDC), nearly every woman will use some form of contraception in her lifetime,¹ whether it be birth control pills, vaginal rings, patches, intrauterine devices (IUDs) or other contraceptives. Yet less than half of women between the ages of 18 and 50 were actually taught about birth control.²

This means that many women are either lacking knowledge about birth control or getting their information from unqualified sources, leading to a wide array of inaccurate guidance around the risks, benefits, side effects, and proper usage of contraception.

To set the record straight, Cady Artmayer, a registered pharmacist with Express Scripts® Pharmacy, is sharing the facts behind some of the most common myths about birth control.

Myth #1: Birth control will make me gain weight

Weight gain is one of the most common concerns when starting birth control. In previous decades, hormonal birth control may have caused some people to gain weight because it contained significantly higher amounts of estrogen and progesterone. At high levels, these hormones can increase appetite and water retention.

However, this is not the case with most current combination hormonal birth control. In reviewing more than 40 studies, researchers found no evidence linking low dose birth control pills, rings, IUDs, or patches with weight gain.³

The only exception to this is the shot. Depo-Provera may cause fluid retention and an increase in appetite, which can contribute to weight gain.

“Patients should discuss their weight gain concerns with their provider,” said Artmayer.

Myth #2: All birth control is hormonal

While many of the more common versions of birth control like “the pill” or patches do contain varying levels of hormones, there are a handful of birth control options that are hormone free. These include barrier forms of birth control like spermicides, diaphragms, and cervical caps. FDA-approved copper IUD ParaGard and hormone-free contraceptive gel Phexxi are two additional birth control options that don’t contain hormones.

Myth #3: Birth control can prevent STIs/STDs

Birth control methods can be very effective at preventing pregnancy, but they do not protect against sexually transmitted infections (STIs). Barrier methods like condoms can reduce the risk of transmitting some STIs.

If left untreated, STIs may damage parts of the body and disrupt normal body functions, becoming a sexually transmitted disease (STD).

Myth #4: Antibiotics decrease effectiveness of birth control

The truth is most antibiotics don’t actually affect contraceptives. The only antibiotics that are proven to decrease efficacy — specifically with hormonal contraceptives — are rifampin (Rifadin) and rifabutin (Mycobutin), which are used in the treatment of tuberculosis.

Just as a precaution, Artmayer recommends that patients always talk to their doctor or pharmacist about their birth control and antibiotic therapy.

Myth #5: Birth control makes you infertile

There is no link between contraceptives and infertility. However, the time it takes to return to your previous fertility after stopping birth control depends on which method you use, said Artmayer.

• Women who take the pill can get pregnant within 1-3 months of stopping combination birth control pills and within days or weeks after stopping progestin-only birth control (the “mini pill”).
• Women who remove an IUD or implant can get pregnant right away.
• For those taking the shot (Depo-Provera), it could take 10 months or more for fertility to return.

Myth #6: The only benefit of birth control is pregnancy prevention

Birth control isn’t only used to prevent unwanted pregnancy. One study found that 14% of women who take birth control pills rely on them exclusively for non-pregnancy related reasons.⁴ These reasons include heavy menstrual bleeding, irregular periods, cramping, headaches, and acne.

Some hormonal contraceptives also suppress ovarian cyst formation, said Artmayer. Ovarian cysts can cause very painful periods and cramping.

Myth #7: All birth control methods work right away

“The timeframe that prescription birth control starts to work can vary depending on the type used and the timing with a woman’s period,” said Artmayer.

While the copper IUD is effective at preventing pregnancy right away, all other forms of birth control can take anywhere from 24 hours to 7 days to become protective.

Artmayer recommends that patients talk to their doctor or pharmacist about different birth control options and whether backup protection is needed.

Myth #8: Birth control causes cancer

Hormonal birth control may slightly increase your risk for breast and cervical cancers, explained Artmayer. But there is significant evidence that birth control decreases the risk of ovarian and uterine cancers and may also decrease the risk of developing colon cancer.

There is also evidence that copper IUDs might reduce the risk of cervical and endometrial cancers.

Let our pharmacists help you separate myth from fact

If you have any questions or concerns about birth control, reach out to your provider or pharmacist. At Express Scripts® Pharmacy, we have specially trained women’s health pharmacists, who are available 24/7.

1 Centers for Disease Control and Prevention: Current Contraceptive Status Among Women Aged 15-49: United States, 2017-2019 (October 2020): https://www.cdc.gov/nchs/products/databriefs/db388.htm.
2 Forbes: Fewer Than Half of American Women Were Taught About Birth Control, Study Finds (August 20, 2020): forbes.com.
3 PubMed.gov: Combination Contraceptives: Effects on Weight (January 29, 2014): https://pubmed.ncbi.nlm.nih.gov/21901687/.
4 Guttmacher Institute: Beyond Birth Control: The Overlooked Benefits of Oral Contraceptive Pills (November 2011): guttmacher.org.