Myths about birth control have long proliferated in the US (thanks in part to the abysmal state of sex ed), but recent events have amplified their spread—namely, the rise of influencers sharing misleading information about the pill on social media and the passage of legislation threatening access to various kinds of contraception.
These misconceptions can have far-reaching repercussions, for instance putting people at risk for unintended pregnancy or keeping them from the non-pregnancy-related upsides of hormonal contraception, like relief from heavy periods and gut-wrenching menstrual cramps. So we asked obgyns to debunk all the biggest birth control myths they’ve heard as of late.
For years, politicians have conflated contraception with abortion, most recently a spokesperson for the US Agency for International Development (USAID), who referred to hormonal contraceptives as “abortifacient birth control” in a statement to The New York Times. The reality is, no form of birth control—not even the emergency kind—is designed to end an existing pregnancy; rather these products keep a pregnancy from getting started.
The two main ways they work are: preventing ovulation (the release of an egg from an ovary), in the case of hormonal contraceptives, and blocking sperm from reaching an egg, either by thickening the cervical mucus (hormonal options) or interfering with sperm motility and function (copper IUDs). All of that prevents a pregnancy from ever being able to get underway, Sameena Rahman, MD, a Chicago-based board-certified gynecologist and menopause specialist, tells SELF.
Where the myth arises may have to do with what happens next. In the extremely rare scenario that a sperm somehow still wriggles its way to an egg and fertilizes it, that fertilized egg may not ultimately implant into the uterus, as both hormonal contraceptives and copper IUDs can cause changes in the uterine lining. But even this doesn’t constitute a negative effect on an existing pregnancy, Dr. Rahman points out, because pregnancy doesn’t start until after implantation occurs, according to the American College of Obstetrics and Gynecology (ACOG). The label on Plan B, a popular brand of emergency contraception, used to suggest it could similarly interfere with implantation, but in 2022, the FDA updated it to clarify that it has no such effect—and only prevents pregnancy by delaying ovulation.
By contrast to all of the above, medication abortion shrinks the uterine lining, causing an already-implanted embryo to detach, and then triggers uterine contractions to push it out.
The only kinds of birth control that protect against both pregnancy and sexually transmitted infections are condoms (both the external kind worn on a penis and the internal pouch you insert into a vagina). As barrier methods, they cut down on the two possible vectors of STI transmission: sexual fluids and skin-to-skin contact.
And even condoms can’t fully eliminate skin-to-skin contact so when you use them, you’re still at risk of getting certain STIs, such as herpes and human papillomavirus (HPV), the virus that causes most cervical cancer. This is why getting tested regularly so you know your STI status is a huge part of staying as safe as possible.
Slipping on a condom just before the person with the penis finishes means their partner gets exposed to pre-ejaculatory fluid (a.k.a. pre-cum), Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF. There’s controversy surrounding whether or not pre-cum always contains sperm, but it’s a possibility, Dr. Streicher says, so you could raise your chances of pregnancy. Not to mention, you won’t be protecting yourself as well as you could against STIs.
“It was previously thought that if your cervix hadn’t dilated during a pregnancy, we couldn’t get an IUD through the cervical canal,” Dr. Rahman says, “but we’ve since learned that we absolutely can.” It’s the reason ACOG even recommends IUDs for teenagers, most of whom of course haven’t given birth.
It is possible that it may be more painful to get an IUD inserted if you haven’t had a child—but there’s no reason it would work any less well to prevent pregnancy. And if the pain worries you, it’s worth chatting with your doctor about the options available for managing it.
Different types of IUDs are recommended for anywhere between three and 10 years. But technically, you could get one removed the day after it was inserted, if you wanted, Dr. Rahman says, or at any point at which you decide it’s no longer for you.
The reason some doctors might push you to keep it in for at least a few months is just to make the most of the hoops you jumped through to get it. As noted, insertion can be painful, and it may not have been cheap, either. Plus, many of the initial side effects, like cramping and erratic bleeding, tend to settle in a few weeks, once your body gets used to this new foreign object and potentially the hormones, Dr. Rahman says. So it may be worth trying to ride out these symptoms versus jumping to removal.
There’s no solid scientific confirmation that either combined hormonal birth control pills (containing estrogen and progestin) or the minipill (progestin-only) causes weight gain. A 2014 review of 49 studies on weight and contraception didn’t find any evidence that combined hormonal contraceptives have a meaningful effect on weight in either direction. And a similar 2016 review of 22 studies just focused on progestin-only forms of birth control found essentially the same thing. That said, if you start a new combination pill, you might feel like you’re gaining because of bloating (the estrogen could make you retain more water than usual).
The only form of birth control that has been explicitly linked with weight gain is Depo-Provera (an injection of progestin you get every three months), as noted in its prescribing info. That likely has more to do with progestin’s appetite-increasing effect than anything else, as the shot packs a higher dose of it than other progestin-containing forms of birth control.
“Your vagina is just a tunnel with an end,” Grace Lau, MD, a board-certified gynecologist at NYU Langone Health, tells SELF. So there’s no chance that a NuvaRing—a hormonal contraceptive in the form of a vaginal ring—can get lost in there.
Typically, you’ll leave the ring inserted for three weeks every month. If you can’t find it when you go to remove it, it might just be stuck high up by your cervix. To get it out of there, take a warm shower and then gently insert your index finger into your vagina and sweep it around until you can feel it. If you’re coming up empty, know that there’s a chance it fell out without you realizing it. But if you really suspect it’s lodged up in there where you can’t grasp it, pay a visit to your obgyn. (And in the meantime, consider using an alternative method of contraception.)
Much like with the NuvaRing, it’s easy to wonder if a Nexplanon arm implant (a progestin-containing device) might take a trip to another spot in your body. But once you have Nexplanon inserted, it’s good for three years—and it should stay put for every minute of them.
While it’s possible for the implant to move slightly in your arm, in the vast majority of cases, it’s not going to budge enough to affect your protection. “Think of your skin like a web of interconnecting strands of collagen and elastin. These fibers trap an implant in place, preventing it from moving in the skin,” Joshua Zeichner, MD, a New York City–based board-certified dermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Medical Center, tells SELF.
The term “fertility awareness-based method” is really a catch-all for a few different tactics of tracking your ovulation. The idea is that during your most fertile times (typically thought to be a few days before ovulation, the day of ovulation, and one day post-ovulation), you should either completely avoid intercourse or use a barrier method to prevent pregnancy.
The problem is, it’s hard to know exactly when you’re ovulating, Dr. Streicher says. The general rule is that ovulation happens on day 14 of a 28-day menstrual cycle, but that doesn’t mean it’ll be true for you every time. And even if you pay attention to possible signals of ovulation, like changes in your basal body temperature, you might not calculate exactly when you’re ovulating properly.
Also, sperm can live inside you for up to five days after having sex. So, if you have unprotected sex because you think you’re not ovulating and then you do ovulate anywhere up to five days later, you could in theory get pregnant.
You’re actually supposed to place the patch (which is sold under the name Xulane) on your upper outer arm, butt, stomach, or back. There, it releases estrogen and progestin into your skin.
You should replace the patch every week for three weeks and also do daily checks to make sure it’s in place. It’s sticky enough that you can wear it in the pool and shower, Dr. Streicher says. If it does fall off, reapply it if it’s still sticky; if not, pop on a new one (and use a backup form of contraception if the old one was off of your body for more than 24 hours).
You can manipulate many forms of combined hormonal contraception, like the combined pill, the patch, and the ring, to skip your period if you want to. The “period” you get on these combined methods is really just a withdrawal bleed that lets you know that you’re not pregnant, Dr. Streicher says. “You don’t ever need to get a period on birth control.”
In order to avoid getting your period while using combined birth control pills, you would generally skip the placebo pills and move right into the next pack. Same thing for NuvaRing and Xulane—you’d bypass the ring-free or patch-free weeks. When it comes to NuvaRing, you can either put in a new one or keep your old one in for a fourth week. With Xulane, you’d need to put on a new patch for that fourth week, because using a patch for over a week can increase your risk of unintended pregnancy.
As you can tell, skipping your period with birth control takes some precise calculation, which is why you shouldn’t just decide to do it on your own. These are off-label uses for these methods, meaning you should talk to your doctor about whether it’s okay for you to use birth control to delay or bypass your period before you try it.
After quitting most methods of birth control, you’ll return to normal fertility within a few menstrual cycles or sooner. The only real exception is the Depo-Provera shot, which has been shown to delay ovulation for 10 months or more in some people.
If you notice you’re having a hard time getting pregnant when you come off birth control, it could simply be that you were on contraception for a long enough time for your fertility to have declined naturally, Dr. Rahman notes. Or your contraception may have been masking an underlying problem that you only discover once you go off of it, Dr. Lau says, like endometriosis or polycystic ovary syndrome (PCOS). Either way, talking to your doctor after coming off birth control can help you maximize your chances of conceiving.
There’s no scientific proof that this is the case, Dr. Streicher says. If you want to go off your birth control to see what your body is like without the added hormones, that’s fine. Just use a backup method of birth control if you don’t want to get pregnant, she says.
Breastfeeding typically causes lactational amenorrhea: It suppresses ovulation and menstruation by disrupting the typical hormonal flow of your cycle.
But it’s important to know that this is not a very secure method of birth control. For maximum efficacy, you’d need to go no longer than four hours without breastfeeding in the day and no longer than six at night. You’d also need to exclusively breastfeed, so no supplementing with formula. Another thing: You’re going to start ovulating again at some point, and it’s hard to know when that might be, Dr. Streicher says.
That’s why ACOG recommends people only use this as a temporary form of birth control for six months maximum or until menstruation starts again, whichever occurs first. And even that’s not foolproof. Let’s say those six months aren’t up yet and you haven’t gotten your period, but you ovulate without realizing it. If you have unprotected sex, you could theoretically get pregnant before your period returns.
If you don’t want to get pregnant again quickly and you don’t use any kind of birth control while you’re breastfeeding, you’re kind of rolling the dice, Dr. Streicher says. (Just avoid birth control pills that contain estrogen during the first four to six weeks after childbirth, as there’s a small chance the hormone could affect your milk supply.)
Yes, it’s very rare that a vasectomy fails, but it is possible, Dr. Streicher says. This procedure involves cutting and sealing the tubes that carry sperm—but all the sperm that’s already been created doesn’t just suddenly vanish into thin air. It typically takes several months (and ejaculating upwards of 15 times) to get all the sperm out of a person’s system after a vasectomy. “You have to have a semen analysis that shows that there are zero sperm left to know if you’re protected,” Dr. Streicher says.
A hysterectomy, which involves removal of the uterus and possibly other reproductive organs, is not typically plan A for the sole purpose of sterilization—it’s a pretty invasive procedure usually done for medical reasons, like treating fibroids or endometriosis (though it also would prevent you from being able to physically carry a pregnancy).
Instead, sterilization typically means getting your tubes tied (a.k.a. tubal ligation). This is where a doctor blocks your fallopian tubes to permanently prevent eggs from being able to travel through them, encounter sperm, and enter the uterus. Alternatively, you might get a salpingectomy, or a removal of your tubes, for the same reason; but in either case, the procedure is less invasive and has a shorter recovery time than a hysterectomy.
Also worth noting: Both tube-related procedures won’t affect your hormones or bring on menopause, whereas a hysterectomy could, if it involves removing your ovaries.
For most healthy women, there’s no reason to give up the pill until age 55, Dr. Rahman points out. Perimenopause can actually be an especially wise time to be on it because so long as you’re having a period, even irregularly, you may be able to get pregnant.
Not to mention the potential benefits of birth control pills for perimenopause symptoms like hot flashes and night sweats—they can temper the hormonal fluctuations of this period, much in the way of hormone replacement therapy (HRT). The main difference between the two is that birth control pills are made up of synthetic hormones and at a higher dose, whereas HRT is a lower quantity of body-identical ones, Dr. Rahman explains. It’s recommended to switch over to the latter once you hit menopause (a year without a period) or age 55, since it may carry fewer risks at this stage. But it does not work as an effective form of contraception, hence why it might be easier to just stay on the pill through perimenopause.
A good doctor will be dedicated to helping you achieve your reproductive goals, whether that’s avoiding ever getting pregnant, putting it off until you’re ready, or helping you get pregnant in the near future. When it comes to your obgyn, there really are no stupid questions.
