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10 myths about the pill busted

By Caroline Tiger
Health.com

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One day you're told that birth-control pills sap your sex drive and make you fat. The next day they're hailed as an easy way to eliminate your period and lower the risk of ovarian cancer.

The constant mixed messages and the sheer number of birth control choices is enough to send you running and screaming toward the nearest condom display. Maybe that's why a recent Health.com poll found that women have trouble separating birth control truth from "truthiness," the Orwellian tendency to believe something regardless of the facts.

Here are 10 myths about the pill and other birth control methods, and why they're not true.

1. MYTH: It's risky to stop your period.

Studies show it's safe to suppress your period using various methods: Seasonale, a pill that limits you to four periods a year; Seasonique, a similar pill that may help fight PMS; or others like Depo-Provera injections that may eliminate your period. "The hormones keep the lining of your uterus thin, so nothing builds up," says Rebecca Gould, M.D., an OB-GYN at Delaware County Memorial Hospital in Drexel Hill, Pennsylvania. Side effects that usually go away include breakthrough bleeding.

Menstrual suppression is great for women with particularly heavy flows, painful cramps and menstrual migraines.

2. MYTH: The pill ups your cancer risks.

Actually, the risk of endometrial and ovarian cancers goes down the longer you're on the pill. After one year, endometrial-cancer risk decreases by 50 percent, and after just three to six months, ovarian-cancer risk decreases by 40 percent. After 10 years, the risks are 80 percent lower than normal. "The longer you keep the endometrium thin and the ovaries inactive, you are reducing the chance of the inappropriate cell division that characterizes cancer," says Katharine O'Connell, M.D., assistant clinical professor of OB-GYN at Columbia University. The pill may also lower the risk of colon cancer.

What about breast cancer? The research is inconclusive. A recent review of previous studies, published in the Mayo Clinic Proceedings, suggests a tiny elevation in risk among current users, which disappears when you quit. (There's no debate for women who have -- or have had -- breast cancer: They should steer clear because the hormones can stimulate some cancerous cells.)

3. MYTH: The pill makes you fat (and frigid).

Most women link the pill to weight gain, but only breakthrough bleeding is a proven side effect. (Women often put on pounds after getting the Depo-Provera injection.) As for libido, while some studies show a decreased sex drive, others show an increase -- a lower chance of pregnancy can be quite an aphrodisiac.

4. MYTH: An IUD ruins your fertility.

The Dalkon Shield, pulled from the market in the 1970s, may have contributed to infections that led to infertility. It was also linked to 17 deaths. But not the new and safe IUDs, such as ParaGard and Mirena. Plus, they're more effective and cheaper than the pill. (Health.com: Is your fertility window closing? )

Cons? Pain during insertion (for about three minutes you'll feel a sensation akin to intense menstrual cramps), and cramps and bleeding that can occur for a week afterward. Also, there's an increased chance of infection during the first three weeks, usually because bacteria have been introduced during insertion; this can be easily treated with an antibiotic, though.

5. MYTH: The sponge is as good as the pill.

The birth control sponge, which blocks the cervix and contains a spermicide, leaves much to chance. Its failure rate is 32 percent for women who have delivered a child vaginally (because the cervix is larger after childbirth); for those who haven't, the failure rate is 16 percent. For better protection, pair it with condoms.

6. MYTH: Long-term use of the pill is a no-no.

Believe this myth and you may risk getting pregnant if you take a break. "This is how my brother was conceived," Gould says. There's no medical reason to stop. It's possible to get pregnant right away after quitting. Half of women get pregnant within three months -- a good reason not to take that break!

7. MYTH: Pill side effects last forever.

The first three months of any new hormonal birth control method bring side effects that eventually go away, Gould says. It's past month three and your doctor's telling you to "gut it out"? Time for a second opinion. (Health.com: A calendar method that works. )

8. MYTH: Taking the pill past age 40 is risky.

You can take it till menopause. But if you're over 35 and you smoke, or have uncontrolled high blood pressure or long-term or uncontrolled diabetes, your heart disease and stroke risks are elevated, and the pill raises them. Anyone who fits this profile is fine on a progestin-only "mini-pill" (or Depo-Provera).

9. MYTH: It's OK to take any medicine with the pill.

St. John's Wort, a popular supplement used for depression, cuts the pill's effectiveness. Researchers think the herb makes your body speed up the metabolism of the pill, preventing the hormones from doing their job. On the flip side, the pill may exaggerate antidepressant effects.

10. MYTH: The pill makes migraines worse.

No, but birth control pills may increase stroke risk in women who suffer from migraines with aura (added symptoms that include numbness, weakness, hallucinations, or blurred vision). For them, the mini-pill and other estrogen-free hormonal methods are OK.

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