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Oral contraceptives: Myth vs. reality

Many women have lingering concerns about using birth-control pills, and that’s understandable. They are, after all, a medication you might take over a long period of time. And they come with a list of possible side effects so long that, after reading it, you might be tempted to switch to another method of contraception. But before you make a hasty decision, read this article. It will dispel some common myths that surround pills, called OCs for short. These myths have their roots in the oral contraceptives of 30 years ago. Today’s OCs have much lower hormone doses, making them not only safe, but also of positive benefit to one’s health.

MYTH: OCs cause cancer.

Many women have heard that birth-control pills cause some types of cancer, including ovarian, uterine, cervical and breast cancers. In fact, studies show that the pill actually protects women from some cancers. After one or two years of use, the pill reduces the risk of developing cancers of the uterus and ovaries. So, for women with a family history of these cancers, oral contraceptives are an especially wise choice.

Although some studies show that users of the pill are twice as likely to develop cervical cancer, it’s not known whether this effect is caused by the pill itself, or by the fact that pill users as a group are more prone to cervical cancer than other women. (Cervical cancer is closely linked to human papilloma virus, which is transmitted through sexual intercourse.) In any case, bear in mind that treatment for cervical abnormalities is so effective that, for women who get regular Pap smears, cervical cancer is rare.

The breast-cancer issue has yet to be fully resolved. A past study found that women who used the pill for 12 years or more, or who used the pill for eight years before delivering their first baby, had a somewhat elevated risk of breast cancer. However, a study conducted by the Centers for Disease Control and several other major studies have found that OCs neither increase nor decrease a woman’s breast-cancer risk.

MYTH: The pill can cause infertility.

A woman’s ability to get pregnant returns soon after she stops taking the pill—usually within two to three months. The pill actually can protect your future ability to get pregnant by reducing your risk of an ectopic pregnancy, spontaneous or induced abortion, and pelvic inflammatory disease—all of which can contribute to infertility.

MYTH: OCs cause birth defects.

For women who stop taking the pill before getting pregnant, there’s no increased risk that the baby will be born with physical abnormalities. There is some evidence, however, that OC use immediately before conception may increase the risk that the fetus will have severe chromosome abnormalities that lead inevitably to miscarriage. To be safe, switch to a barrier form of birth control (diaphragm, condom, sponge or cervical cap) two or three months before attempting to conceive.

There is an extremely slight increase in risk of birth defects for women who inadvertently take the pill while pregnant. For all pregnancies, the risk of having a baby with a birth defect is about 30 per 1,000. For women who have used the pill while pregnant, that risk is 31 per 1,000.

MYTH: Women who take the pill are at increased risk of heart attack or stroke.

The pill doesn’t raise a woman’s risk of a heart attack unless she’s a heavy smoker, has a vascular disease like diabetes or high blood pressure, or is older than 35, when the risk of heart attack increases regardless of pill use. As for stroke, the pill basically has no effect on younger women. It may increase the risk of stroke for a woman over age 40, but that risk is still slight. In fact, the Food and Drug Administration has ruled that healthy women who don’t smoke can continue to use the pill after age 40 and even right up until menopause.

Research shows that over the course of any given year, the pill saves lives by protecting women against cancer, ectopic pregnancy and pelvic inflammatory disease. The pill also protects against benign breast disease and ovarian retention cysts. By keeping a woman’s periods short and light, the pill helps to prevent anemia and reduces cramping. And, of course, the pill remains a convenient, reversible and highly effective form of contraception.