The pill continues to fuel debate more than 35 years after it was first legalised, and there are still numerous misconceptions circulating.

Information about contraception tends to be poor thanks to growing rumours and the number of abortions among young women continuing to rise. There never ceases to be a huge focus on misconceptions. We are going to discuss some of the most common misconceptions here.

I’VE HEARD THAT THE PILL…

…makes you fat

WRONG! This is probably the most commonly discussed stereotype. The pill can increase your appetite, especially in the first month of taking it. You simply have to watch your diet to avoid eating more than usual, until your body adjusts to the hormones.

…can be taken continuously so that you don’t get a period

TRUE! The period you have when on the pill is not natural: it is artificially induced by the 7-day break (or by the placebo pills). It is therefore possible to take your pill without a break after the 21st pill, and run on 2 or 3 packets without it being dangerous. Don’t hesitate to talk to your doctor or gynaecologist to confirm that the pill will still be just as effective.

…decreases your libido

TRUE and WRONG! Depression, fatigue, stress, everyday worries, are all factors that could cause women to lose their libido! However, some pills that have an effect on testosterone levels can also be responsible for these problems and hence lower your libido. Some women find that they experience a wave of desire during their ovulation period. Because the pill gets rid of this phase, it can mean that women no longer feel this wave of desire and hence their libido feels decreased. In any case, the best solution is to talk with your doctor or gynaecologist about your loss of libido so that they can tell you the real reason. If it’s down to the pill, they might suggest you try a new type of contraception or change pill.

…is 100% effective

WRONG! The pill’s effectiveness is very high, at over 99.7%. This means that less than 1% of women using this form of contraception perfectly (with no problems) get pregnant during their first year of use. This level of success can decrease due to forgetfulness, side effects like nausea and diarrhoea, interactions with other medication, etc.  Here are some tips to follow when taking the pill (such as Dianette, Cerazette, Qlaira, Yasmin, Microgynon): take your pill in the morning and carry it with you during the day: you’re more likely to be able to repair any mistake you might make like forgetting a pill. If you usually take the pill in the evening and you forget, it’s often too late to repair the damage by the morning. Warning: you must change this habit at the beginning of a pack. Try to think of taking your pill as an everyday activity (like putting on makeup, brushing your teeth, etc.) or set an alert on your mobile.

…is less effective when you take other medication as well

TRUE and WRONG! Some drugs reduce the effectiveness of the pill. These include TB drugs, antivirals—especially in the treatment of AIDS—and epilepsy drugs. If you start a new treatment, then you should check with your doctor to make sure it doesn’t interact with the pill to avoid any mistakes. Remember to read the label on your treatment as well.

…can be taken a few times to make up for if I forget one

TRUE and WRONG! If you have forgotten a pill or taken it at a different time from normal, check the pack to find the maximum delay before there is a risk of pregnancy. It is 3 hours for some pills (progesterone-only) and 12 hours for others (combined pill). If you remember within these times, take the missed pill immediately (even if this means taking two on the same day) and then take the next one at its usual time. There will be no risk of pregnancy. If you only remember after this period, you should take the missed pill immediately (even if this means taking two on the same day). However, there is a risk of pregnancy if you have sex in the following days, so use a condom for the next 7 days. If your pill is a combined pill and you forget one of the last 7 pills in the packet, you should start the next packet immediately after finishing, without taking a break or taking the placebo pills.

…protects you from sexually transmitted infections

WRONG! The pill only protects you from the risk of pregnancy. The only way to be protected from AIDS / HIV and sexually transmitted infections is to use a condom (male or female).

…makes you infertile

WRONG! The contraceptive pill does not cause infertility whether you are taking it for just a few months or several years. Your body might just need to go through a cycle or two after you stop taking the pill before it finds its natural rhythm for you to get pregnant.

…is just like the other contraceptives

WRONG! The morning after pill counts as “emergency contraception”. You can use it within 72 hours (3 days) of having unprotected sex. This “catch up” pill gives you a much bigger hormonal overdose than the traditional pill and should only be used in exceptional cases. The emergency contraceptive pill only works within 72 hours of having sex. If you had sex over 72 hours before taking the pill, you are not protected. This is why you should use a condom until your next period. It is important to talk to your doctor or gynaecologist to help you find the best contraceptive method for your health.

…could get me pregnant on the week-long break between packets.

WRONG! The combined pill simply puts ovulation to sleep. Ovulation “wakes up” after one week of breaking from the pill (or the 7 placebo pills). Therefore, you are protected for the 7-day break, but no longer than that.

…is effective from the first pill

WRONG! If you take a combination pill it takes one week (7 days) for ovulation to stop. Therefore, if you take the pill on the first day of your period you are immediately protected against pregnancy. However, you must use a condom for a week if you start during a different time in the cycle, for protection. If you think there might be a risk you are pregnant, you should take a pregnancy test before starting the pill.

…is incompatible with tobacco

TRUE and WRONG! Tobacco can only cause problems and increase cardiovascular risks when combined with the combined pill (oestrogen and progestogen) or the mini pill. The risk of an incident is lower if you are younger than 35. However, you should tell your doctor or gynaecologist if you are a smoker.

…can lead to phlebitis

TRUE! Pills are drugs (see point on “I’ve heard that the pill…is not a real drug”). A drug is not just any old product – it has both advantages and disadvantages, including the side effects mentioned in the warnings. Vascular complications caused by the pill are rare. It comes with a risk of arterial thrombosis (stroke, myocardial infarction) regardless of the generation of pill used. The risk of venous thrombosis (phlebitis, pulmonary embolism) is on average two times lower with second generation pills than when using 3rd and 4th generation pills, but the risk still exists. Therefore, when a doctor or midwife prescribes the pill, they will look at your risk factors during the consultation (e.g. pre-existing vascular diseases, smoking). They will also think about possible contraindications and specific monitoring needs. (Source: Questions – answers about the contraceptive pill – ANSM – June 26, 2013)

…is not a real drug

WRONG! The pill is a drug. It comes with risks and side effects like any other medication. This is why it is prescribed by a doctor, a gynaecologist or a midwife. When you first ask for a contraceptive pill prescription, you will have to have your blood pressure taken as well as answer a few questions about whether you smoke or drink. You will also be asked about your general health and your family history. The doctor simply wants to identify any potential family and personal history (e.g. diabetes, cholesterol, breast cancer and other diseases or risk factors) to make sure that there is no problem with you taking the pill. If this is the case, then the doctor might suggest an alternative like the IUD, an implant or condoms.

Medical review on March 10, 2017 by Dr. Davis Taylor

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