There’s much to remember about contraception and many half-truths and plain lies floating around. Here, the International Planned Parenthood Federation debunks 10 of the most popular myths around the topic.
Contraception has revolutionised the way we live our lives, allowing us to decide whether and when to get pregnant and even allowing us to time our periods, reduce acne and maintain that element of control over our lives that comes from being able to control our fertility.
From the copper coil, to condoms, to the pill – or multiple pills – there are so many different types of contraception, as well of lots of misconceptions, and it can sometimes be difficult to decide which method of contraception suits you best.
On World Contraception Day, 2021, Nathalie Kapp, Chief Medical Advisor for the International Planned Parenthood Federation and an obstetrician-gynaecologist who specialises in women’s health busts some common myths around contraception and shares IPPF’s contraception quiz, so you can decide which contraceptive method might be right for you.
1. Contraception damages your fertility
A common myth about hormonal contraception is that long-term use can affect fertility, making it difficult or impossible to get pregnant after stopping use. This is untrue, and whether you’ve had a copper coil in for ten years or taken the pill for fifteen, you’ll have a normal return to fertility once you stop using contraception – assuming there are no other fertility issues at play. The Depo-Provera injection is an exception, with research suggesting the hormones can stay in your system and delay return to fertility for a few months.
2. You can’t have an IUD fitted if you haven’t had children
The IUD is either a hormonal, or non-hormonal T-shaped device that sits in the uterus. Some people don’t want to use the IUD because they incorrectly believe that it shouldn’t be used by young people or those who haven’t yet had children. In fact, IUDs are safe for a wide range of people. There is no minimum or maximum age for one although an IUD should be removed after menopause. There is also no requirement that you must have children to use the IUD.
Case study: Chea
Chea, 30 from London, uses the Mirena IUD, a hormonal device that releases a type of the hormone progestin. It can provide long-term birth control for up to five years and can be removed at any time for a quick return to normal fertility. Chea doesn’t have any children.
“I’ve had the Mirena hormonal IUD since 2017. I actually wanted to get the non-hormonal IUD (copper coil) because after being on the implant for around eight years, I wasn’t sure if I wanted to use hormonal contraception. But, after speaking to a nurse at Dean Street Clinic in London, she advised me that the Mirena IUD might be a better option for me as the copper coil can make periods heavier, and I get painful periods anyway. I’ve found the Mirena IUD really good. I don’t really have periods, just the motions sometimes and a little bit of spotting. I like that it lasts for five years as it takes away the worry of sorting out contraception, and I can get on with my life.
“For me, good contraceptive care is when you are listened to, and your experiences are taken into account – contraception can be complicated, and we’re all very different. I like the contraceptive clinics as they tend to have good clinical knowledge and are non-judgemental - it’s also great when you can walk in instead of booking an appointment. It’s important for me that my partner understands the importance of contraception because it isn’t just my responsibility - my partner came with me to get my IUD fitted. Having access to contraception is a weight off my mind, and I can imagine that life would be a lot more difficult if I didn’t have it.”
3. Contraception makes you put on weight
Most people don’t gain or lose weight long-term due to their contraception and weight normally fluctuates due to changes in age, life circumstances or fluid-retention. Because changes in weight are common, many women attribute their natural weight gain or loss to their contraception, but studies have found that there is no link. The Depo-Provera injection is an exception, and weight-gain is often seen in the first few months.
4. The contraceptive pill can cause cancer
While the pill changes the levels of hormones in the body which can slightly increase the risk of early, curable, breast cancer compared to those who aren’t taking it, it also significantly decreases the risk of other cancers, such as ovarian and cervical cancer. Ovarian cancer in particular is a difficult cancer to catch early and has high mortality rates. While, overall, the benefits outweigh the risks, each person is different so it is worth talking to your doctor if you have any concerns.
5. You can’t take the combined pill without a break
The effectiveness of the pill depends on a regular intake of the hormones contained in it. Until recently, women were advised to have a seven- day break from the pill to mirror their ‘natural’ cycle, but research has shown that breaks are unnecessary and for some, the break from hormones may result in an unintended pregnancy. Pills and hormonal contraception in general can safely be used for many years without stopping them, but of course, you can take a break if you want.
6. Contraception is only for cis-gendered women
While many people still view contraception through the narrow lens of cisgender-heterosexual women preventing unintended pregnancy, contraception is for everyone. Trans people, non-binary folk, gender fluid people, and people with a uterus can also become pregnant. Contraception is also a key barrier in reducing exposure to STI’s, and yes, this means you may want to consider using condoms with your sex toys and dental dams if you’re unsure of your or partner’s status.
7. Hormonal contraception is the only type of contraception
There are lots of different types of contraception and many people use ones which contain hormones such as the pill, implant or the hormonal IUD. However, there are other effective options which don’t use hormones, including the copper IUD, condoms, female sterilisation and vasectomy. The best contraceptive method is the method that a person wants to use and can use and the one which best fits with their lifestyle.
8. Only women or people who can become pregnant who have to worry about contraception
Worryingly, a lot of people assume that the responsibility for contraception lies solely with those who can get pregnant, but there are effective methods which can be used by men. Condoms are the most popular form, and protect against pregnancy and STIs while the less common method of vasectomy offers a long-term solution for those who don’t want to have children or don’t want any more children. While male forms of hormonal birth control are in the pipeline, they’re not publicly available yet.
Case study: Rachel
Rachael, 29, from Shropshire, exclusively uses condoms after finding that hormonal contraception didn’t suit her. Condoms are 98% effective when used correctly and about 85% effective with typical use – they protect against pregnancy and some STIs. Rachael is mum to a little boy, age two and is expecting her second child - she stopped using condoms with her partner before each pregnancy.
“Condoms have been my only form of contraception. I went on the pill for two weeks to stop my period when I travelled around India, but travelling anxiety coupled with new hormones in my system didn’t work for me. I decided to stick with condoms - I like them as there is no change to my normal cycle.
“My partner has never questioned my choice to use condoms, and we used them from when we met in 2014 until we started trying for a baby in 2018, and again after we started having sex once I recovered from labour in 2019. I have often said I would love for men to have the option of a pill, as it’s generally on women to take something, and it needs to be more equal.
“For me, good contraceptive care comes from someone informative and understanding of your situation, someone who has the time to discuss various options and what’s right for you and someone who doesn’t judge and roll their eyes at ‘we’re going to use condoms’. When you leave the hospital after birth, they have to ask you what contraception you’re going to use. The very thought of having sex made me both laugh and become very nervous, but although the first time post labour was scary, it was fine!
“I also think there needs to be a bigger focus on real sex education at school or in young adulthood. I really struggled to have sex when I was younger as I found it painful. I went to my doctor, and the answer I got was that I was uptight and nervous. So, actually, for me, going back a step and understanding more about my body and sex, learning about female pleasure and not just pregnancy, would have been useful.”
9. Emergency contraception – ‘the morning after pill’ – causes an abortion
Emergency contraception is not an abortion, and it can only prevent a pregnancy providing you haven’t already ovulated, not end a pregnancy that has already started. Emergency contraception is a higher dose of hormones, which prevents or delays ovulation and can be taken up to 72 hours after you have sex.
10. Contraception is 100% perfect
Simply put, no contraception is 100% effective and some people will fall pregnant regardless of using it correctly. If your contraception has failed or you’ve been caught out, it’s OK to use emergency contraception, which can decrease your chance of getting pregnant substantially as long as you haven’t ovulated and aren’t already pregnant. If you are pregnant and don’t want to be, you can access abortion care to end your pregnancy safely.