Since its invention in 1960, the birth control pill has been one of the most contentious and significant developments in women’s health. Illegal in Canada until 1969, its controversy has raged on through the years, as have its misconceptions. Now, as the wars over women’s rights, reproductive rights, and sex ed access continue, understanding the basics of birth control grows more important than ever.

“The Pill” can be a confusing concept, especially with its many contradictions. It’s important to understand how birth control pills work—what they do and not do—so we want to give you information about the myths that surround oral contraceptives.

Myth #1: The Pill Will Make Me Gain Weight

Truth: It’s pretty rare to gain an abnormal amount of weight while taking birth control pills.

In various studies comparing people of the same age who are and aren’t on the pill, the average amount of weight gain is about the same. If a person does gain a little bit of weight when they start taking birth control pills, it is often a temporary side effect that’s due to fluid retention. Read more about this in our article on what you need to know about weight gain and birth control pills!

 Myth #2: Birth Control Will Make my Acne Better / Worse

Truth: Not all oral contraceptives help acne and not all acne responds to the pill as a treatment.

There is a direct relationship between hormones and most acne. Most breakouts are triggered by an excess production of oil that clogs pores and promotes the growth of bacteria. Women normally have a low level of androgens circulating in their bodies, and higher levels can lead to increased or excess oil production.

Taking birth control pills that contain both estrogen and progesterone (“combination” oral contraceptives) lower the circulation of androgens, resulting in less oil and less acne

(birth control pills that contain only progesterone can actually make acne worse). An initial flare-up of acne is common when a woman first starts taking combination birth control pills and this method works only on acne that is the result of excess oil production.

Though typically safe and effective, birth control pills for acne aren’t for everyone. Side effects can include headache, breast tenderness, nausea, weight gain, breakthrough bleeding and a slightly increased risk of blood clots.

 Myth #3: The Pill will Make Me Lose my Hair
Truth: Some people find that their hair is not affected by the pill at all.

Whether or not your hair will react to birth control pills depends on how sensitive your hair follicles are to the hormones the pill contains. It also depends on your body chemistry, your genetics and how your body metabolizes the medication.

Thinning hair is a genetic condition, and if you have it, once it is triggered (by increased androgens), your hair follicles become gradually smaller and hair grows back thinner.

Some birth control pills can slow or stop this process because they increase your estrogen levels and/or diminish your testosterone levels. Other contraceptive pills can raise your levels of androgens and trigger or increase this process.

 Myth #4: Birth Control Will affect My Mood

Truth: Mood is an elusive element to measure because it is self-reported and the perspective of the individual.

The results of a study, published in the Journal of Epidemiology in 2013, show that young women using the birth control pill or other hormonal methods of birth control were no more likely to be depressed than other young women. Meanwhile, other studies have cited the opposite.

If you experience mood side effects, consult with your physician. It may mean that your birth control pill or your method of birth control needs to be changed. If you have a history of clinical depression, you may not be able to take birth control pills.

Myth #5: Being on Birth Control Will Make it Harder to Get Pregnant in the Future.

Truth: The pill has no negative impact on fertility.

 Some women experience a delay in resuming ovulation and menstruation following birth control use, but when compared to women not on the pill, their fertility rates were similar. In 2009, researchers followed almost 60,000 oral contraceptive users to track their fertility rates after stopping the pill. About 20% got pregnant in their first cycle after stopping and 80% within the first year.

Interestingly, researchers have discovered that longer-term use of oral contraceptives actually improved the likelihood of pregnancy. According to the research, women who had taken medications for more than four or five years were more fertile than those who had used them for less than two years.

Myth #6: The Only Reason to Take Birth Control is for Contraceptive Use

Truth: If you’ve read this far you know this is definitely a myth.

Yes, birth control pills can help you avoid pregnancy, but the pill can have other amazing medical benefits like less painful and more regular periods, less severe PMS, and a lowered risk for some types of cancer.

Regular Periods: Birth control pills can help regulate your period so you know when it’s coming, shorten your cycle or even stop your period for a few months to a year at a time. They can also make your periods lighter, lowering your risk for heavy bleeding which lowers your risk of anemia. The pill may also ease painful cramps because it prevents ovulation.

PMS: If you have PMS (premenstrual syndrome) or PMDD (premenstrual dysphoric disorder), birth control pills may ease mood swings, breast soreness, menstrual-related migraines, weight gain, bloating, and acne by balancing out your hormone levels.

Endometriosis and Ovarian Cysts: While birth control pills don’t cure endometriosis or ovarian cysts, they may help to control endometriosis-related pain by stopping ovulation and thinning your endometrium (the innermost lining of the uterus) and they may also keep ovarian cysts from coming back.

Polycystic Ovary Syndrome: PCOS is a hormone imbalance in which the ovaries make extra amounts of testosterone. It can cause irregular periods, unwanted hair growth, and acne. Taking birth control pills can improve these symptoms by balancing your hormones, lowering the level of testosterone, and regulating your period.

A decision to take birth control pills needs to take into account your medical history. Certain medical conditions could become worse if you use an oral contraceptive. Talk to your doctor about how your health history and age may affect your risks with birth control pills.

Remember: Birth control pills now contain lower doses of hormones than they did in the past, which has significantly lowered its risks. Still, taking oral contraceptives does contribute a higher risk of side effects, including heart attack, stroke and blood clots.

Written by: Jennifer Hamilton