It has rained a lot since the use of the contraceptive pill was authorized for the first time in the US in the 1960s, and today it is one of the most widely used methods to prevent unwanted pregnancies.
Since the first hormonal contraceptives, considerable progress has been made and many of the adverse effects that were more common among the first women to use the pill have been minimized. However, there is still a certain ‘black legend’ about this drug that, although it is not without contraindications – it is still a drug administered for very long periods of time – it is very safe.
“The first pills that were marketed carried high doses of hormones. It was a way to ensure the contraceptive effect but it also implied many adverse effects ”, explains Virtudes Roig, pharmacist and author of El Blog de Pills. “Over the years, these concentrations have been decreasing, seeking the minimum amounts with contraceptive capacity in order to reduce adverse effects. Other of the most important evolutions have been the commercialization of pills for continuous intake that allow only four menstruations a year, pills that contain only progestogen or those that have variable concentrations of hormones in order to make them as close as possible to the hormonal cycle natural woman ”.
In this article we are going to review which of the topics that circulate about the contraceptive pill are true, and which are a hoax.
After taking the pill for a while it may cost more to get pregnant
“This statement is not correct,” explains Ruth Aguiar Couto, gynecologist at the Ron Obstetrics and Gynecology Team at the Quironsalud A Coruña Hospital. “The amount of time it takes for a woman to be fully fertile again after stopping a hormonal contraceptive method varies for each woman and depends on the contraceptive method used .”
It should also be taken into account that fertility gradually decreases with age, so obviously “after stopping any form of contraception, a woman may have more difficulty getting pregnant, simply because she is older than when she started to use contraceptive methods ”.
According to Dr. Aguiar, ” about 50% of women become pregnant in the first three months after stopping the contraceptive pill , and most women become pregnant within the first twelve months.”
In addition, the doctor reminds us that the use of oral contraceptives just before a pregnancy does not increase the risk of miscarriage or fetal problems , so there is no problem when pregnancy occurs just after stopping the pill.
The contraceptive pill causes breakthrough bleeding
Yes, and also this is probably one of the most common side effects , especially during the first months of taking, confirms Roig.
“Bleeding is more common with continuous dose or extended cycle pills, it can be experienced in about 50% of women during the first three months of use. After this time, the percentage of women who present it is reduced to 10% ”, adds Aguiar.
Women who take the pill have a higher risk of thrombosis
During the first years of generalization of the contraceptive pill, it was observed that women who took it had a higher cardiovascular risk. This was mainly due to the high composition of estrogens and gestagens. Currently, the doses have been reduced in such a way that these effects have been greatly reduced, although they have the disadvantage that they regulate the cycle worse, and this is the cause of intermenstrual bleeding, Aguiar explains.
Women over 35 cannot take the pill
This is another aspect in which the contraceptive pill has evolved since its inception. Because age is a factor that in itself increases the risk of cardiovascular disease, traditionally the use of hormonal contraceptives was limited to young women. However, these risks have also been minimized and, as Aguiar reminds us, “the age limit has been extended so that they can be used by women over 35, as long as there are no contraindications”.
In 2016, in addition, an extensive review published in the journal Maturitas that analyzed the risks and benefits of hormonal contraceptives in women over 40 years of age concluded that they are safe, as long as the person is healthy at the beginning of their intake.
Taking the pill can make you fat
The two experts consulted agree that this statement is false. “It is important to clarify that what can occur is fluid retention -not fat- “, explains the pharmacist. “It seems to me an important point. Furthermore, as we have commented, this inconvenience is no longer so frequent with the low-dose contraceptives that are currently used ”. Dr. Aguiar confirms it: “Contraceptives can cause fluid retention in the first months, this being responsible for the moderate weight gain, but the usual trend is towards normalization after the first three months of use .”
In addition, the doctor reminds us that contraceptives are taken for a very long period of time, and throughout the months it is very common for a person to lose weight or gain weight due to multiple factors that have nothing to do with the pill. “In the last decades dozens of studies have been published and compared in meta-analyzes to try to demystify the relationship between weight gain and the use of hormonal contraceptives. What studies show is that women can gain or lose weight due to multiple factors (changes in lifestyle, poor diet, decreased physical activity). Over 6-12 months it is very common for patients to vary in weight, whether or not they are taking hormonal contraceptives ”, he explains.
So what are the main side effects of the birth control pill?
In addition to breakthrough spotting and fluid retention that we have already discussed, the most common adverse effects of hormonal contraceptives are nausea, decreased libido, headache, and breast tenderness and enlargement. “Reducing the intake of caffeine and salt in the diet helps reduce this symptom,” says Aguiar. “Some of the side effects could decrease with continued intake. You should consult your gynecologist in case these symptoms persist ”, he recalls.
“There is another frequent side effect that does not have such an impact on health but that is of great concern”, adds Roig. “It is about the appearance of spots (melasma) associated with taking oral contraceptives. That is why we insist a lot from the pharmacy on the importance of using sun protection associated with taking contraceptives ”. In addition, the pharmacist reminds us that “the risk of venous thrombosis episodes, although low, exists, and is more associated with overweight women or smokers.”
In conclusion, advances in medicine and pharmacology have allowed considerable evolution over the almost sixty years of life of the contraceptive pill. Current drugs are less harmful and produce fewer side effects because the doses of hormones have been reduced , and this allows, as Dr. Aguiar explains, “that users can take them for a longer time without risk, as long as they are under control. gynecological. In addition, it is no longer necessary to perform the classic ‘rest periods’ every so often ”.
The contraceptive pill is 98-99% safe and reliable, but provided it is used correctly. “It is important to respect the hourly regulation and take it every day and at the same time,” Aguiar recalls. “In this way, fluctuations in hormonal levels that can lead to the failure, with the consequent unwanted pregnancy, of this method are avoided.”
It is worth remembering, on the other hand, that the contraceptive pill does not protect against sexually transmitted diseases, so it is a recommended method only if you have a stable partner.
Note: Ruth Aguiar Couto, works in the Quironsalud Hospital unit directed by Roque Devesa, a member of Top Doctors.
