The Birth Control Pill Doesn't Cause Infertility, and 7 Other Things to Know About It

July 22, 2014. 9:07 p.m. Twenty-something feminist and Twitter user extraordinaire Lena Dunham tweeted: “I need birth control because I have endometriosis and it helped manage pain. Why do you?” The replies poured in, and after starting a dialog heard ‘round the Internet, Dunham directed her many fans to follow the Planned Parenthood Action Fund for more information.

As Dunham highlighted, whether or not you’re trying to prevent pregnancy, or are even sexually active at all, the birth control pill has its uses. There are a variety of reasons to go on the pill beyond the most obvious ones. Still, misperceptions about its uses and benefits abound.

I turned to Planned Parenthood Federation of America to discuss one of the most common forms of contraception around. Below, Dr. Vanessa Cullins, OB/GYN and Vice President for External Medical Affairs at PPFA, answers questions to help you decide if the pill is the right choice for you.

What Is The Birth Control Pill?

Most birth control pills are a combination of two hormones — estrogen and progesterone — which work together to prevent ovulation. If taken as directed, the birth control pill is 99 percent effective.

Who Is A Good Candidate For The Birth Control Pill?

Unless you don’t feel that you can handle the responsibility of remembering to take the pill every day (ideally at the same time each day), it’s a good option for birth control. It is well-researched and well understood by doctors, it is cheap or free under most health insurance, and it is easy to stop or start using in a planned way. That being said, Cullins suggests not treating a breakup as a reason to stop taking contraception. "You never know when a new one will start, or an old one might start back up, and there is some lead time for effectiveness,” she advises.

Can I Use The Pill To Skip My Period? (Or, Are Periods Really Necessary!?)

Actually, yes (and no). Since menstruation is viewed as a coming-of-age ritual of sorts in our society, the idea that it is not in fact a necessary “cost” of womanhood can be tough to wrap your head around. But, according to Cullins, menstruation is quite frankly not much but the tangible evidence that you completed your cycle without getting pregnant.

Does The Pill Make You Gain Weight?

Unfortunately, there is no easy answer to this common question. Some women who go on the pill actually lose weight, some will gain weight (although not much), and many will stay the same. However, Cullins points out a very important oft-forgotten correlation: Two things tend to happen as women age. The first is that many women do gain weight as they get older. The second, and this can be a byproduct of the first, is that many people (not just women!) settle into more sedentary lifestyles as they get older and start their careers. Given these factors, measuring whether or not birth control causes weight gain is a complicated issue. You should pay attention to your body and its reactions, but you should not be afraid that taking the pill is a guaranteed path to weight gain.

Does The Pill Cause Mood Swings?

According to Cullins, surveys of large populations of women show that there is an almost even split between those who find the pill affects their mood and those who don’t. That doesn’t mean you have to give up birth control. “You have to try particular formulations of birth control to see how they will affect you. If you have mood changes that don’t agree with you, change to another hormonal formulation or a non-hormonal birth control method,” she advises.

Does The Pill Affect Fertility?

Contrary to popular myth, the pill not only has no negative impact on fertility but is actually sometimes used to aid fertility. If you lead a healthy lifestyle, don't smoke, and are in normal health, you can conceive pretty much immediately after stopping the pill.

How Does The Pill Affect Skin?

All combined hormonal birth control pills (estrogen and progestin) are shown to improve acne. However, Cullins notes that the extent to which improvement occurs will depend on the individual. There is no way to predict which pill will work best for an individual suffering from acne. It’s a trial-and-error process to find which formulation will best prevent or reduce it for you. Improved skin isn’t the only perk of the pill, either — it can help women with endometriosis and debilitating cramps, and protect against anemia.

Should I Take A Birth Control Pill Hiatus?

One of the more frustrating myths about the birth control pill is that it’s in some essential way dangerous and that if you do use it, you shouldn’t continue use for years and years. “The pill exists in a lot of different forms today that we didn’t have when it was first manufactured in the 1960s,” Cullins says. It is both safer today and also contains lower quantities of hormones than earlier versions. There’s no reason a woman cannot stay on the pill for as long as she is seeking to prevent pregnancy.

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