10 Facts About the Pill and Contraception

Understanding how the pill works and using it correctly can help you avoid unwanted pregnancy, irregular bleeding, or hormone imbalance. That's why it's essential to learn all you can about the pill. By educating yourself, you can make better choices about contraceptives.

Since the pill's approval on May 9, 1960, it's been one of the most carefully studied medications in history. Women's knowledge has significantly improved since the pill became available, but misinformation still exists. And some women wonder whether it causes adverse effects like bloating or weight gain.

Here are some common pill facts you should know. Hopefully, they will clear up any confusion about this birth control method. 


The Effect on Weight Is Minimal

Teenage girl with the Contraceptive Pill

BSIP / UIG / Getty Images

Does the birth control pill make you gain weight? It's a common question. 

While some people seem to gain weight on the pill, research has shown no association overall between weight gain and birth control.

The estrogen in the pill can make some people feel bloated. This can make you feel as if you weigh more even if you don't. But this effect typically goes away. 

The progestin in the pill may increase your appetite. In turn, you may eat more. Eating more can lead to weight gain if not balanced with diet and exercise.

Also, some people may experience water retention. Switching to a lower-dose pill can reduce this effect.

People often start using the pill during a time of life that corresponds with weight changes. Although the weight changes are usually unrelated, this contributes to the pill's reputation for causing weight gain.


There's No Need to Take a Break

Should you take a break once in a while from the pill? There's no medical reason for a healthy person to do so.

You can take the pill consecutively as long as you need it. Still, doctors recommend reviewing your contraceptive needs after 15 years of using the pill or at age 35.

The pill is one of the most effective contraceptives. Taking a break may increase your risk of getting pregnant if you're sexually active. You should know that it's possible to get pregnant immediately after stopping the pill.

On the other hand, you might have underlying fertility issues you're not aware of when you're not trying to get pregnant. Irregular periods and other signs that point to fertility problems might only emerge when you stop taking the pill. 

So, intermittently stopping the pill makes sense if you're not sexually active. It can be a good time to check in with what your hormones are doing. If you take a break, pay attention to whether you are ovulating and your periods are regular.


The Pill Is Safe to Use

Some people question whether the pill is safe or if it can cause complications. 

Be assured: The birth control pill is one of the world's most researched and prescribed medications. Experts confirm it's a safe and well-tolerated contraception method.

The pill hasn't been linked to any congenital disorders (birth defects), even if accidentally taken during early pregnancy.

About 151 million women worldwide use the pill. For many women, their quality of life is better while taking the pill than when not.

It can minimize premenstrual syndrome (PMS) symptoms. The pill can also help regulate your menstrual cycle, so you know exactly when you will have a period (known as a "withdrawal bleed").

You can also use it to skip your period. Or you can choose an extended cycle pill that reduces the number of periods you have each year. These pills are entirely safe as well.


Long-Term Use Doesn't Affect Fertility

There's no connection between taking the pill and infertility. Fertility can return almost immediately after stopping the pill. That's why it's important not to miss one of your pills.

Some people may face a delay in becoming pregnant after stopping pill use. This is especially true for those who had irregular periods before starting it.

Age is one of the reasons for the confusion about the pill and infertility. Many people who use the pill delay childbearing until their late 30s. This is a time when female fertility naturally begins to wane.


Not All Pills Are the Same

Some believe that all birth control pills are the same. However, there are different brands and varieties of birth control pills. They can contain different levels of hormones. Or they may have different doses at various times throughout each pill pack cycle.

Oral contraceptives fall into two main categories: 

Each pill brand may affect a person's body chemistry differently. They may also offer slightly varying benefits or side effects. Talk to your doctor about your concerns to help you find a pill that's best for you.


Smoking and Overweight Are Risks

If you smoke, be honest with your doctor about it. Women who smoke have a higher risk of having a stroke.

Women aged 35 years and older have a higher risk of stroke and blood clots if they use the pill and smoke. For this reason, most doctors won't prescribe combination pills for women over 35 years who smoke.

Women who are overweight or obese may also be at greater risk for oral contraceptive failure. However, the research isn't clear, as noted in a 2016 review of 12 studies.


Missing a Pill at Any Time Is Risky

Some people believe that the riskiest time to miss a pill is in the middle of the pack. This is based on the idea that a woman's most fertile time is during days eight through 19 of a typical cycle.

However, you don't have a regular menstrual cycle when you use the pill. Since you don't ovulate, there's not a time when you are more fertile.

Suppose you use a typical 28-day (four-week) combination birth control pill. In that case, you need to take seven consecutive days of active pills to prevent ovulation. No ovulation means no egg for a sperm to fertilize and no chance of becoming pregnant.

The first week (week one) of taking pills is the most critical. It's less risky to miss pills in the middle of a pack (weeks two and three). Missing pills at the end of week four may mean you haven't taken the pills needed to stop ovulation during the next month.

The most unsafe time to forget a pill is at the beginning of the pack or at the very end. Forgetting to start your next pack on time extends the pill-free/placebo week past seven days.


There Are Other Uses for the Pill

The uses of the pill go beyond contraception. In addition to pregnancy prevention, the following hormonal options provide health benefits: 

Women may use the pill and other hormonal contraceptives solely for non-contraceptive advantages, such as:

Additionally, for some women, pill use can provide protection against:

  • Excess facial and body hair
  • Ectopic pregnancy
  • Acne
  • Noncancerous breast growths
  • Ovarian cysts and cancer
  • Pelvic inflammatory disease
  • Osteoporosis
  • Menstrual migraines

Women Over 35 and Teens Have Unique Concerns

Some women can use lower-dose pills until menopause. This includes women who:

  • Have normal blood pressure
  • Don't have an increased risk of heart attack or stroke 
  • Don't smoke  

The pill may be especially beneficial for perimenopausal (around menopause) people in their mid-to-late 40s who have heavy or irregular periods.

prescription is the only way to get the pill. In general, healthcare providers don't need a parent's permission to prescribe the pill to a teenager, but this varies with state laws. Teenagers have to show the healthcare provider they understand the risks and benefits of their decision.

Pills, IUDs, and implants are proven to be safe and effective in teens. However, starting the pill is a big decision, so teens may want to talk about it with a parent or trusted adult first.


The Pill May Affect Risk of Some Cancers

Some people worry that the pill can cause cancer. For most women, this isn't entirely true. Generally speaking, using the pill doesn't increase your overall cancer risk.

In fact, the pill can have a protective effect against certain cancers. For people at average risk for cancer, the pill may reduce the risk of ovarian, endometrial, and colorectal cancers. 

Research is limited for people who have a higher risk of cancer because of family history.

Some research does show slightly increased risks for some cancers, such as breast, cervical, and liver cancers.

The risk of breast cancer is dependent on many factors, such as:

  • Your age when you first started menstruating
  • Your age at menopause
  • Your age at your first pregnancy
  • Not having children

All of these factors can change hormone levels and affect breast cancer risk.

Long-term use of contraceptives is associated with a higher risk of cervical cancer. However, the risks generally decrease over time after stopping the pill.

The effects on liver cancer risks are not well-defined. Studies looking into this association with the pill are inconsistent.

A Word From Verywell

Birth control pills have varying effects on different people. Every one of us is different. Only you and your doctor can determine whether the pill (and which pill) is right for you. Ask your doctor any questions you have and share your concerns.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.