Some myths, like that you can always blame Mercury retrograde for whatever’s going wrong in your life, are pretty harmless. Others, like many of those surrounding birth control, can lead to real consequences, such as unintended pregnancy.
Unfortunately, there’s ample opportunity for birth control myths to spread. Only 57 percent of sexually active young women and 43 percent of sexually active young men said they’d received formal instruction on birth control before first having sex, according to a nationally representative 2016 study in the Journal of Adolescent Health that surveyed 2,125 teenagers between the ages of 15 and 19.
It seems there’s some serious and necessary room for improvement in sex ed these days. Unfortunately, we can’t create a comprehensive sex education curriculum and distribute it to every school in the country. But we can get to the bottom of common birth control myths, so that’s exactly what we did here.
Myth #1: Using any form of birth control means you’re protected against sexually transmitted infections.
The only kinds of birth control that protect against both pregnancy and sexually transmitted infections are male and female condoms. As barrier methods, they cut down on the two possible vectors of STI transmission: sexual fluids and skin-to-skin contact.
With that said, condoms can’t fully eliminate skin-to-skin contact, which means that even when you use them, you’re still at risk of getting certain STIs, such as herpes and human papillomavirus (HPV). This is why getting tested regularly so you know your STI status is a huge part of staying as safe as possible, even if you use condoms whenever you have sex. Find out how often you should get tested here.
Myth #2: You can have a little sex then throw on a condom before any ejaculation happens, and you’ll still be just as protected against pregnancy.
Condoms can be a good form of birth control if you’re committed to using them perfectly each time. That involves putting on male condoms before any sex happens and keeping them on until after ejaculation has occurred, according to the Centers for Disease Control and Prevention (CDC). What do you know! Same thing goes for female condoms.
The issue is that sometimes people will start off having unprotected sex, then put on the condom before the person with the penis finishes, Lauren Streicher, M.D., an associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF. This can introduce the person with the vagina to pre-ejaculatory fluid (which you probably call pre-cum). There’s controversy surrounding whether or not pre-cum always contains sperm, but it’s a possibility, Dr. Streicher says, so your chances of pregnancy might increase if you do this.
It’s estimated that two women out of every 100 will get pregnant within the first year of using a male condom perfectly, but that number jumps to 18 with typical use, which could include putting on a condom too late (or using one without inspecting it for tears, using the wrong size, using it past its expiration date, or doing anything else that can compromise the effectiveness of the condom). For female condoms, five women out of 100 will get pregnant in the first year with perfect use, and 21 out of 100 will wind up pregnant with typical use.
Plus, if you do this, you’re not protecting yourself as well as you could against sexually transmitted infections. The takeaway: Use condoms the way you’re supposed to every single time.
Myth #3: If you haven’t had children, you’re not a good candidate for an IUD.
Nope, nope, nope. There’s a reason the American College of Obstetricians and Gynecologists (ACOG) recommends long-acting reversible contraceptives like IUDs for teenagers, most of whom obviously haven’t given birth.
Here’s the deal: If you’ve pushed out a baby vaginally, your cervix has had some practice dilating significantly. Therefore, the theory is that it may not hurt as much when your medical practitioner pushes your IUD past your cervix and into your uterus during insertion.
That doesn’t mean you can’t get an IUD if you haven’t given birth—it should work just as well to protect you from pregnancy, and people’s pain experiences when getting IUDs vary whether or not they’ve had kids. “There is no reason not to put an IUD In someone who hasn’t had children,” Dr. Streicher says.
Myth #4: Once you get an IUD inserted, you absolutely have to leave it in for years.
IUDs are recommended for anywhere between three and 10 years, based on the kind you pick. (Here’s more information about each type.)
Some doctors recommend you keep your IUD in for at least a year for two reasons, Dr. Streicher says. For one, although your insurance may completely cover your IUD, they can cost hundreds of dollars or more depending on your coverage and the type of IUD you choose. Also, the insertion process doesn’t exactly feel like a trip to the spa. So, just in terms of a cost-benefit analysis (and pain-benefit analysis), it often makes sense to keep your IUD for a bit.
Of course, sometimes you’ll decide your IUD’s time is up even though it’s technically still good for use. This may be because you’ve decided an IUD isn’t for you (here are some ways to know one might not be) or because you want to get pregnant. Either way, your doctor should respect your wishes and go through with the removal. Here’s what you can expect from that process.
Myth #5: You always have to take the pill at the exact same time every day, no matter which kind you use.
OK, so this is kind of true. If you’re taking the minipill, it uses the hormone progestin to protect you from pregnancy by thickening your cervical mucus so it’s harder for sperm to get through, along with thinning your uterine lining so there’s not much nourishment for a fertilized egg. The minipill may also suppress ovulation, but it’s not guaranteed.
Since the minipill relies on only one hormone to keep you pregnancy-free, and since it’s at a lower dose than combined hormonal pills, much of its efficacy hinges on taking it as close to the same time every day as you can, according to the Mayo Clinic. If you take it more than three hours after you should, your protection is compromised and you should use a backup form of birth control for at least two days (like condoms).
If, on the other hand, you’re on a combined hormonal birth control pill, the estrogen in it will work to reliably suppress your ovulation, and you’ll also have higher levels of progestin. That means you have some more wiggle room with when exactly you take the pill, Grace Lau, M.D., a gynecologist at NYU Langone Health, tells SELF. While you would ideally create a habit of taking your combined hormonal pill at the same time every day just so you never forget it, if you do miss one, you can generally take it as soon as you remember, then resume taking the others at their normal time. You typically only need to use a backup method of contraception if you missed your combined pill by more than 12 hours, according to the Mayo Clinic, although you should always check the exact prescribing methods from the manufacturer to be sure.
Myth #6: Birth control pills will make you gain weight.
“I get asked about this a lot,” Dr. Lau says. There’s no solid scientific confirmation that either combined hormonal birth control pills or the minipill cause weight gain, she explains.
A 2014 review in Cochrane Database of Scientific Reviews looked at 49 studies on weight and contraception, ultimately finding that there wasn’t enough evidence showing that combined hormonal contraceptives have any large effect on weight either way. A 2016 review in Cochrane Database of Scientific Reviews looked at 22 studies surrounding progestin-only forms of birth control and essentially found the same thing. With that said, if you start a new combination pill, you might feel like you’re gaining because of bloating (the estrogen might make you retain more water than usual).
The only birth control that is explicitly linked with weight gain is Depo-Provera (often called “the shot,” it's an injection of progestin you get every three months), which the Food and Drug Administration specifically points out in the shot’s prescribing information. (The weight gain may be because of appetite changes.) If that’s something that matters to you, bring it up with your doctor when discussing your contraceptive options.
Myth #7: The ring can get lost inside of your body.
NuvaRing, also called “the ring,” is a little flexible plastic ring that you insert into your vagina for three weeks every month. The ring contains a mix of estrogen and progestin to help prevent an unintended pregnancy, the Mayo Clinic explains. Though you may feel nervous that this little device can get lost up there while doing its job, there’s really no need. “Your vagina is just a tunnel with an end,” Dr. Lau says. “There’s no way for it to get to the rest of your body.”
If you think your NuvaRing is “lost,” it might just be stuck high up by your cervix. Try these methods to get it out, or go see your ob/gyn. There’s also a chance that the NuvaRing could have fallen out without you realizing it. Either way, you may need to use a backup method of contraception until you can get back on track—here’s how to know if that’s necessary.
Myth #8: The implant can move around your body.
Much like with the NuvaRing, it’s easy to wonder if your Nexplanon arm implant might take a little trip to another spot in your body.
The birth control implant is a rod-like device about the size of a matchstick that’s inserted under the skin in your inner upper arm. There, it releases a steady dose of progestin to help prevent an unintended pregnancy, according to the Mayo Clinic. 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, M.D., a New York City–based board-certified dermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Medical Center, tells SELF.
Myth #9: Fertility awareness-based methods are just as effective as birth control pills at preventing pregnancy.
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, according to ACOG), 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 rule of thumb is that ovulation happens on day 14 of a 28-day menstrual cycle, but that doesn’t mean it’ll be true for you; this can change due to things like stress or hormonal problems. Plus, not everyone has a 28-day menstrual cycle.
Even if you pay attention to possible signals of ovulation, like an uptick in cervical mucus (the fluid your cervix typically produces that becomes thinner and slipperier before ovulation to help sperm access an egg) or changes in your basal body temperature, you might not calculate exactly when you’re ovulating properly.
Also, sperm can live in you for up to five days after having sex, according to ACOG. So, if you have unprotected sex because you think you’re not ovulating, then you do ovulate anywhere up to five days later, you could in theory get pregnant.
Estimates suggest that 24 out of 100 women who use fertility awareness-based methods become pregnant in the first year. Birth control pills, however, have a typical use failure rate of 9 out of 100 women in the first year. So, while fertility awareness-based methods may work for some people, there’s a bigger margin for error involved than there is with other methods.
Myth #10: You can put the birth control patch anywhere on your body.
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. The patch is sticky enough so that you can wear it in the pool and shower, Dr. Streicher says. If it does fall off, your next steps depend on if it’s still sticky enough to reapply and how long it’s been detached from your skin.
Myth #11: It’s unhealthy to use birth control that does away with your period or to use birth control to skip your period.
Some forms of birth control, like hormonal IUDs, may result in you not getting a period because the progestin in them prevents you from building up much of a uterine lining. But you can also 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,” she says. “There’s no benefit to it. None. Zero.”
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 absolutely need to talk to your doctor about whether it’s OK for you to use birth control to manipulate your period before you try it.
Myth #12: Taking hormonal birth control can mess up your fertility down the road.
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, according to the Mayo Clinic.
If you notice you’re having a harder time than expected 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. It could also be that your contraception was masking an underlying problem that you only discover once you go off of it, Dr. Lau says. Either way, talking to your doctor can help you make sure you’re maximizing your chances of conceiving.
Myth #13: Your body needs to take a break from hormonal birth control sometimes.
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, Dr. Streicher says.
Myth #14: You don’t need birth control if you’re breastfeeding.
Breastfeeding typically suppresses ovulation and menstruation, according to ACOG. This is called lactational amenorrhea, and it happens because breastfeeding disrupts the typical hormonal process necessary for your ovaries to release eggs.
Here’s a huge caveat, though (and we’d put it on a billboard if we could): This is not an especially 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, according to ACOG. 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. 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. Instead, you may want to choose a birth control option that offers more security, like an IUD, the implant, barrier methods like condoms, or a birth control pill without estrogen since there’s a small chance the hormone could affect your milk supply, according to ACOG.
Myth #15: You 100 percent can’t get pregnant if your partner has a vasectomy.
Yes, it’s very rare that a vasectomy fails, but it is possible.
When a person has a vasectomy, it means doctors cut and seal the tubes that carry sperm, the Mayo Clinic explains. 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, according to the Mayo Clinic.
“[Many ob/gyns have] stories of how one of their patients got pregnant this way,” Dr. Streicher says. “You have to have a semen analysis that shows that there is zero sperm before you’re protected.”
Myth #16: Female sterilization means getting a hysterectomy.
“A hysterectomy and tubal ligation are completely different,” Dr. Lau says. It’s true that getting a hysterectomy, which is removal of the uterus and possibly other reproductive organs as well, means you won’t be able to physically carry a pregnancy. Female sterilization (also known as a tubal ligation or getting your tubes tied) has the same result, but a different process.
In order for you to get pregnant, an egg has to travel from one of your ovaries into one of your fallopian tubes, which is where fertilization happens. So, during tubal ligation, a doctor will cut, tie, or otherwise block your fallopian tubes to permanently prevent eggs from being able to travel through them and encounter sperm, the Mayo Clinic explains. That’s as opposed to a hysterectomy, which may involve removing the fallopian tubes, but doesn’t include manipulating them to decrease the odds of pregnancy.
Also worth noting: a tubal ligation would not bring on menopause, whereas a hysterectomy may bring on menopause only if it involves removing the ovaries.
If you have any questions about these or other birth control myths, talk to your doctor.
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 ob/gyn (and your health in general), there really are no stupid questions.
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