Last week, we answered some frequently asked questions about the pill, or oral contraceptives.

Unfortunately, women all over the world share many misconceptions about these. For instance, a research study of 2,700 pill users in Scotland, conducted in the year 2000, revealed that almost one third of the respondents believed that oral contraceptives worked by killing all sperm cells.

Others think it could make you infertile or that it has a 100 per cent success rate. In this article, we tackle some common myths about birth control pills.

Note: This article is not intended to promote oral contraceptive pills. Birth control pills might not be the right choice for every woman
 
Myth 1: "The pill makes you fat"

Fact: Not necessarily.

At one point in time, birth control pills contained high levels of estrogen (female sex hormone)and progesterone (hormone involved in the female menstrual cycle and pregnancy).

While weight gain was a side effect of the older higher dose pills, the birth control pills available today do not necessarily cause weight gain. According to a study conducted in the year 2,000, it was estimated that in the first year of use:

~ 20 to 25 per cent women gain more than 2 kg.

~ 60 per cent women experience no change or have a weight change within 2 kg (includes both increase and decrease).

~ 15 to 20 per cent women actually lose more than 2 kg weight.

Myth 2: "The pill protects us against STDs including HIV"

Fact: The pill does not protect a couple against STDs or HIV.

The only way to reduce the risk of HIV or other STDs is by using barrier contraception such as condoms, consistently and correctly.

Myth 3: "If I continue taking birth control pills even if I am pregnant, this will automatically cause an abortion"

Fact: No, taking the pill does not cause an automatic termination of pregnancy. If your pregnancy test is positive, consult your doctor for further steps.

The pill however, can be used for 'emergency contraception'. Usually, this consists of taking two birth control pills at a time immediately (or for up to five days after the act of intercourse) and two pills 12 hours after the first dose. This course, if administered properly could reduce the risk of pregnancy by 80-90 percent. It is also known as the "morning after pill".

However, please remember that the number of pills in a dose is different for each pill brand, and not all brands can be used for emergency contraception. If you think your birth control failed, you did not use contraception, or you were forced to have sex, ask your doctor about this option immediately.

Myth 4: "Oral contraceptives can cause birth defects"

Fact: Birth defects have not been associated with taking today's low-dose birth control pill before pregnancy. But, what if you are on the pill and become pregnant accidentally?

Dr Aruna Sathe, a practicing gynecologist from Mumbai says, "The chances of getting pregnant while on the pill are very low but this could happen. Some women continue taking the pills without realising they are pregnant. Then when they do discover they are pregnant, they panic. Recent research has showed that low-dose birth control pills taken during the first few weeks of pregnancy should not be a cause for concern".

Myth 5: "If I am on the pill, I cannot possibly get pregnant. The pill is infallible."

Fact: Unfortunately, the pill is not entirely foolproof. The stated effectiveness of birth control pills is 96-99 per cent.

However, the actual effectiveness depends entirely on how the pills are used. In reality, the effectiveness is much lower, around 87 per cent. This difference can be attributed entirely to user habits. Taking the pill at different times of the day, missing days or skipping pills reduce the effectiveness of birth control pills.

Myth 6: "If I take the pill for a few years, I could become infertile"

Fact: Not exactly. The pill only suppresses ovulation; it does not damage the ovaries. It may take a few months for cycles to return to normal for women who take the pill for longer periods.
It is usually recommended that women wait for two menstrual cycles once they are off the pill, before they try to get pregnant.

Myth 7: "I should take frequent breaks from birth control pills to avoid side effects"

Fact:  Research does not show any proven benefit from taking a break from the pill.

Discontinuing the pill without effective back-up contraception can lead to an undesired pregnancy.  Your gynecologist is the best judge of how long you can take the pill.

Myth 8: "The pill can cause cancer"
 
Fact: The pill actually reduces incidence of cancer of the ovaries and cancer of the endometrium (the lining of the uterus).

Women taking the combined oral contraceptive pill have a higher incidence of cervical cancer but a direct causal link has not been established. Other research studies have suggested that women who use the oral contraceptive pill may be less likely to use condoms and thus could be more at risk of being exposed to the genital human papilloma virus (which is considered to be one of the causes of cervical cancer).

A slightly higher incidence of breast cancer is reported among women who take the pill, but the exact correlation is not known.

In any case, women who have had breast, uterus or liver cancer must not take the pill

Myth 9: "Birth control pills will make my period heavier"

Fact: In fact, the reverse is true. Most women on the pill experience a lower degree of menstrual cramps, menstrual pain, and PMS symptoms.

Their periods are also likely to be lighter and shorter than before they started taking the Pill.

. Do consult your physician before you decide to start taking oral contraception.

-- The author has an MBBS from KEM Hospital, Mumbai, with a Masters in Nutrition from the University of Texas at Austin.