5 Myths and Facts About Birth Control

With so many available forms of birth control to choose from, it’s important for you and your partner to understand all contraception options before finding the one that’s right for you. But it’s hard to make an informed decision about birth control if you can’t separate fact from fiction. From birth control pills causing cancer to emergency contraception causing abortion, here is the truth behind five persistent birth control myths.

We all know (or have heard about) someone who has gotten pregnant in spite of birth control. But it’s a mistake to assume that means birth control isn’t reliable as a rule. In cases when pregnancy occurs with the use of birth control, the most common culprit is user error—not the performance of the contraception itself.

When used correctly, birth control pills, the hormonal patch, the vaginal ring, and intrauterine devices (IUDs) all have failure rates of less than 1%. Condoms are 98% effective when used properly and without breaking. Even under typical use situations–which include such real-world events as forgetting to take a pill and condom breakage–birth control pills, the patch and vaginal ring are 91% effective; condoms, 82% effective. IUDs are more than 99% effective, even in real-world scenarios.

Because many hormonal forms of birth control contain estrogen and some cancers, particularly certain types of breast cancer, are strongly linked to estrogen, women who are concerned about breast cancer risk have been reluctant to use hormonal birth control. But while some studies show a slightly increased risk of breast cancer in women who use birth control pills, a 1996 study found the risk decreases after women stop taking the pill and disappears completely 10 years later. Because this increase in risk is tiny and temporary, and because most women take the pill in their 20s and 30s, when their risk of cancer is low anyway, most experts believe birth control does not meaningfully increase the risk of cancer in most women.

Birth control pills and other forms of hormonal contraception actually decrease a woman’s risk of ovarian and endometrial cancer. That’s because these forms of birth control suppress ovulation, resulting in a net decrease in the amount of reproductive hormones a woman is exposed to over her lifetime. According to the National Cancer Institute, taking the pill for five years or longer may cut your ovarian cancer risk in half, and that protection may last up to 25 years. Taking the pill for at least four years can slash your risk of endometrial cancer by half, and that protection seems to last for 10 years.

Over the years, there has been concern that birth control pills and IUDs could interfere with the implantation of a fertilized egg into the uterus. For those who believe life begins at the moment of conception, such interference would be akin to abortion.

Not the pill. Not IUDs. Not even emergency contraceptives (better known as the “morning-after pill”). IUDs work because they keep sperm and egg from meeting each other. Oral birth control pills prevent ovulation; which means no egg is available for sperm to fertilize. And though early on, some people thought emergency contraception worked by preventing implantation of fertilized eggs into the uterus, there is no scientific evidence to suggest that’s what happens. Instead, emergency contraceptives also delay ovulation so that fertilization cannot occur.

If you want to get pregnant someday, you may worry about the effect of birth control on your fertility. But science says using birth control will not hinder your fertility long-term. In most cases, your fertility will return within a month of stopping contraception. One exception: Women who discontinue birth control in their late 30s may well have a difficult time conceiving, but that’s likely due to the effect of age on fertility, not the effect of contraception.

Barrier methods such as condoms prevent the transmission of sexually transmitted diseases (STDs), a common cause of female infertility. And women who use the pill decrease their risk of endometriosis and uterine fibroids, two conditions that commonly decrease fertility.

Some women shy away from certain forms of birth control because they think it’s too expensive. They may have heard, for instance, that an IUD can cost up to $1000, or that birth control pills cost up to $50 per month.

Most women should be able to access birth control at no or low cost. Under the Affordable Care Act, health insurance companies are required to include contraceptive coverage. Companies aren’t allowed to charge you a co-payment or deductible for contraceptive-related healthcare visits either, if you see an in-network provider. Some employers and organizations are exempt from that requirement, though. If you don’t have insurance, or your insurance doesn’t cover contraception, check with your local county health department and Planned Parenthood. Some have programs that provide free birth control, or charge a sliding scale fee based on your income.

Bottom line: Discuss your contraceptive needs with your healthcare provider. Double check your health insurance policy to see which options are covered. With a little effort, you should be able to find a safe and effective form of birth control that meets your needs.