Jennifer Ashton, M.D., Ob-Gyn with Christine Larson WebMD Feature by “The Body Scoop for Girls”
My patient Lori wasn’t having much luck with the prescription-strength NSAID drug or the complementary remedies she tried, so I suggested oral hormones. She hesitated.
Did You Know?
The Pill Can Reduce Some Cancer Risks
Oral hormones are one of the only ways to reduce your risks of ovarian cancer. That may be because you don’t ovulate when you’re on the pill—and scientists think that one type of ovarian cancer happens at least partly because monthly ovulation damages the ovary’s outer capsule. Multiple pregnancies and pro-longed breast-feeding also prevent the ovaries from releasing eggs and seem to offer the same benefit.
Using oral hormones for a long time can also reduce uterine cancer. When the uterus is exposed to too much estrogen, without progesterone, it can cause abnormalities in the uterine lining, which can lead to cancer. Oral hormones reduce this risk by controlling the levels of progesterone and estrogen.
False or False? Myth-Perceptions About the Pill
Here are a few common myths and misunderstandings about the pill.
You have to start on a Sunday.
FALSE. Your body has no idea what day of the week it is.
The pill causes weight gain.
FALSE. I’ve said this before, but it’s worth repeating, since this is such a common concern. The pill has no calories. You might retain a little water, but if you gain more than two or three pounds, blame something else.
Taking the pill for a long time can make you infertile.
FALSE. Your body’s own hormonal system kicks back in just a few days after you get off the pill. It has no affect on your future fertility.
You need to take a “break” from the pill now and then.
FALSE. There’s no need to take a month or a year off the pill at any time.
You need to take one week off the pill every month.
FALSE. Actually, in some cases, and with some formulations of the pill, you don’t need to take a week off in order to have a period. So you could go several months without having a period. There are no bad effects from controlling your cycle with the pill so that you skip periods altogether for several months.
Certain medications can affect the pill, making it less effective. If you’re taking any of the following, it’s even more important that you use a second method of birth control—or you may end up pregnant despite your faithful pill popping.
St. John’s wort
The antibiotic Rifampin, which is used to treat tuberculosis
Did You Know?
You Can Get Pregnant on the Pill
Even when women take the pill faithfully, every single day, exactly as prescribed, one in one thousand still gets pregnant. And 80 percent of women don’t take it perfectly—they miss a pill now and then. In this typical instance, eight in one hundred women will get pregnant while on the pill.
“This’ll sound dumb,” she told me, “but I really don’t want to gain weight.”
“Don’t worry, that’s just a myth,” I told her.
Lori’s mother was nervous about the pill for a different reason—she was worried I was giving Lori a permission slip for sex. But when I explained the benefits and risks, Lori and her mom decided oral hormones were a good idea.
FAQ: Top Questions about the Pill
Will I gain weight? Unlikely. The pill has zero calories. Most people don’t gain any weight on the pill. A few girls do gain one or two pounds, probably due to fluid retention. But it’s not enough for anyone to notice. If you gain more than ten pounds, the culprit is probably not the medication but your eating habits or a hormonal situation.
Does the pill cause cancer? Many people think the pill has been linked to all kinds of cancers. Actually, oral hormones are one of the only ways to reduce your chances of developing ovarian and uterine cancer. In fact, a woman can reduce her risk of ovarian cancer by as much as 50 percent by taking the pill!
Isn’t the pill linked with breast cancer? Lots of studies have been done to determine whether oral hormones increase or decrease breast cancer risk. The current consensus among most leading experts is that it does not significantly increase breast cancer development—but it may increase the rate of breast cancer detection.
What about cervical cancer? Cervical cancer is very rare. Oral hormones do seem to slightly increase your risk, but we don’t understand why. In fact, it might be that women taking birth control pills may be less careful about always using condoms—and unprotected sex leads to a greater chance of getting HPV, which can lead to cervical cancer. But it’s also possible that oral hormones change the cells of the cervix and make them more prone to HPV infections and subsequent cancer.
Bottom line: If you take oral hormones, have gotten the HPV vaccine, and—once you’re no longer a virgin—always use condoms during sex, cervical cancer is not a significant risk, in my opinion.
Who shouldn’t take the pill? There is one group of people who shouldn’t take oral hormones: those with rare clotting disorders. The pill can increase the risk of blood clots in the leg, the lung, or the brain (a clot in the brain causes a stroke).
For most people these are very small risks. But if you have a close family member who had a blood clot in the leg (called a deep vein thrombosis) or the lung (a pulmonary embolism) or who had a stroke, or if your mother had a lot of miscarriages, you may be at higher risk. Your doctor can perform blood tests to see if you have a clotting disorder that would make the pill a bad idea for you.