Oral contraception — or “the pill” — is still the most popular method of birth control in the United States. For many women, it truly is a girl’s best friend! Sadly, there are more urban legends and myths about the safety and side effects surrounding the pill than almost any medication out there. Did you know that 50% of pregnancies in the US are unplanned? The pill is one of the most effective tools we have to change that — but preventing pregnancy is just the beginning of what it can do.

What Is the Pill, Exactly?

The birth control pill is a daily oral medication that contains synthetic versions of the hormone’s estrogen and progesterone (or progesterone only, in the “mini-pill”). These hormones work primarily by preventing ovulation — no egg released means no pregnancy possible. But those same hormones have powerful effects throughout the entire body, which is why the pill has so many benefits beyond contraception.

There are many different types and combinations of estrogen and progesterone available, which means the pill can be tailored to your body, your symptoms, and your lifestyle.

What We Don’t Love About the Pill

Let’s be honest, no medication is perfect. Some women do experience side effects, especially in the first few months. These can include:

• Irregular bleeding or spotting
• Nausea
• Breast tenderness
• Bloating
• Headaches
• Acne (in some cases)
• Increased appetite or weight changes
• Emotional changes, especially depression
• Brown spots on the face (called melasma)
• Worsening of migraines
• No protection against sexually transmitted infections, so using a condom is a MUST!

The important thing to know is that these side effects are usually temporary. If they don’t improve within 2 to 3 months, don’t give up on the pill entirely, talk to your doctor about switching to a different formulation. There are so many options that the right one for your body almost certainly exists.

What We LOVE About the Pill

Here’s where it gets good. The benefits of the pill go way beyond preventing pregnancy:

Period Problems? Solved.

• Periods become lighter, shorter, and more regular
• Painful cramping is significantly reduced or eliminated
• Heavy bleeding is controlled
• PMS symptoms are improved

For women who dread their period every month, this alone can be life-changing.

Skin Benefits

The pill — particularly combined estrogen/progesterone pills, is an FDA-approved treatment for acne. By reducing androgen levels, it decreases oil production and keeps breakouts under control. It’s also commonly used to treat the excess hair growth (hirsutism) associated with PCOS.

Hormonal Conditions

The pill is one of the most effective treatments for:

• Endometriosis— a condition where uterine tissue grows outside the uterus, causing severe pain. The pill reduces the growth of that tissue and provides significant pain relief.
• PCOS (Polycystic Ovarian Syndrome)— regulates irregular periods, reduces excess hair growth, and helps balance hormone levels.
• Fibroids— the pill can help control the heavy bleeding caused by uterine fibroids.

Cancer Protection

This is one of the most powerful and least talked-about benefits of the pill. Long-term use provides meaningful protection against several cancers:

• Ovarian cancer— risk is reduced by up to 50% with long-term use, and that protection continues for years after stopping
• Uterine (endometrial) cancer— risk is significantly reduced
• Colorectal cancer— studies show a reduced risk in pill users

Bone Health

Estrogen plays a key role in maintaining bone density. The pill helps preserve bone strength, which matters especially for women with conditions like amenorrhea (absent periods) or those at risk for osteoporosis.

Migraine Relief (for Some)

While the pill can worsen migraines in some women (particularly those with aura, see below), for others — especially those who get menstrual migraines tied to their cycle, a continuous or low-hormone pill can actually reduce the frequency and severity of headaches.

Covered by Most Insurance Plans

Thanks to the Affordable Care Act, most insurance plans cover FDA-approved contraceptives, including the pill, at no cost. That’s a win.

Most Common Myths About the Pill — Busted

“I’m going to gain weight!”

Study after study does not show weight gain to be a proven side effect of the birth control pill. The time when most women start the pill, adolescence, going off to college, early adulthood, also happens to be a time when many women naturally gain some weight, which is likely why this myth persists. The association is misleading.

“The pill will make me infertile.”

Absolutely no evidence supports this. In fact, fertility typically returns within one to three months of stopping the pill. Some women get pregnant the very next cycle. The pill does not damage your reproductive system in any way.

“I’ll get breast cancer.”

There is no strong evidence that the pill significantly increases breast cancer risk for the vast majority of women. In fact, as noted above, the pill actually protects against ovarian, uterine, and colorectal cancers. As always, discuss your personal and family history with your doctor.

“I need to take a break after being on it for a long time.”

There is absolutely no medical reason to support this. The pill is safe for long-term continuous use. You do not need to “give your body a rest.” This myth has led many women to have unintended pregnancies for no good reason.

“The pill is only for sexually active women.”

Nope! The pill is prescribed regularly to women and teens who are not sexually active, to treat painful periods, acne, endometriosis, PCOS, and more. It is a medical treatment, not just a contraceptive.

Who Should NOT Take the Pill

The pill is not right for everyone. You should not take the combined estrogen pill if you:

• Have high blood pressure
• Have a history of blood clots or strokes
• Are over 35 and smoke
• Have migraine headaches with aura(visual disturbances before the headache)
• Have certain liver conditionsor a history of certain hormone-sensitive cancers

This is why having an honest conversation with your healthcare provider about your full medical history is so important before starting any hormonal contraceptive.

 

The Bottom Line

Oral contraception has a remarkable range of health benefits that go far beyond preventing pregnancy. For most women, the benefits significantly outweigh the risks. Whether you’re managing painful periods, fighting acne, protecting against cancer, or treating a hormonal condition, the pill may be doing a lot more for your health than you realize.

As with any medication, the key is finding the right pill for your body with the guidance of a doctor who listens to you. You have options, you have choices, and you deserve to feel your best.