Oral contraceptives, or commonly known as the birth control pills, are hormone-containing medications that women take to prevent pregnancy. An oral contraceptive is widely used among Malaysian women and can be purchased from a pharmacy.
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In general, the oral contraceptive is a reliable method of preventing pregnancy, i.e. there is a 7% failure rate typically. On the other hand, the use of condom has a 13% failure rate. Nevertheless, oral contraceptive does not protect one from sexually transmitted diseases (STD), which the condom does.
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Here are some of the common misconceptions associated with oral contraceptives.
Misconception 1: Oral contraceptives are dangerous and can cause birth defects.
Around the world, there are a total of 151 million women of reproductive age (15-49 years) take oral contraception. It is one of the most researched, well-studied and safe medications in the market.
A study has confirmed that oral contraceptives will not increase the risk of future birth defects, even if you accidentally took one during early pregnancy. However, if you do conceive while taking progestin-only birth control (minipill), there's a slightly higher chance that the pregnancy will be ectopic.
With that being said, there are certain groups of people who are not advisable to take oral contraceptives. You should consult a doctor or pharmacist if you would like to start taking oral contraceptives.
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Misconception 2: Using oral contraceptives long-term can reduce fertility.
Oral contraceptive use regardless of its duration and type does not reduce a women’s fertility or delay fertility even after discontinuation.
Misconception 3: The oral contraceptives make you gain weight.
Weight gain is thought to be a side effect of oral contraceptives. Many women and healthcare providers believe that pills cause weight gain. While the available evidence is insufficient, this study found that there is no significant association between oral contraceptives and gaining weight.
From a physiologic standpoint, oestrogen, one of the hormonal ingredients in oral contraceptive, can cause water retention and bloat. However, this effect tends to wane away over time and is not thought to cause significant weight gain. The water retention effect can be easily tackled by requesting to switch to a pill with a lower dose.
Additionally, women often begin using the pill during a time of life that happens to coincide with weight changes. This may also contribute to the pill's unfair reputation for causing weight gain.
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Misconception 4: Smokers and obese women cannot take any oral contraceptives.
If you are a heavy smoker and/or obese, your doctor may not advise you to take oral contraceptives, particularly the combined oral contraceptives. This is because both smoking and obese are risks factors for cardiovascular and thromboembolic diseases respectively, and the risk can be potentiated by the use of oral contraceptives.
That being said, it doesn’t mean that smokers and obese women cannot take oral contraceptives. Other alternatives such as a progestin-only pill or intrauterine device (IUD) can be used for these individuals. Your doctors should be able to discuss these options with you.
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Misconception 5: Oral contraceptives increase the risk of cancer.
Before we discuss the effect of oral contraceptives on the risk of cancer, it is helpful to understand that the majority of studies on the association between oral contraceptives and cancer risks comes from observational studies. The data from these kinds of studies cannot definitively establish a clear relationship between oral contraceptives and cancer risk. That is because women who take oral contraceptives may differ from those who don’t take them in ways other than their oral contraceptive use, and it is possible that these other differences—rather than oral contraceptive use—are what explains their different cancer risk.
With that being said, many studies have provided consistent evidence on the link of oral contraceptives and cancer risk. Interestingly, oral contraceptives increase the risks of breast and cervical cancers but lower the risks of endometrial, colorectal and ovarian cancers.
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Breast cancer: Among women who are taking combined oral contraceptives and in the 10 years after stopping, there is a small increase in the relative risk of having breast cancer diagnosed. The longer the duration of stopping the oral contraceptives, the lower the risk becomes. Another study found out that women who were using or had recently stopped using oral combined hormone contraceptives had a modest (about 20%) increase in the relative risk of breast cancer compared with women who had never used oral contraceptives. The risk increase varied from 0% to 60%, depending on the specific type of oral combined hormone contraceptive.
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Cervical cancer: One study found a 10% increased risk for less than 5 years of use, a 60% increased risk with 5–9 years of use, and a doubling of the risk with 10 or more years of use.
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Endometrial cancer: The risk is reduced by at least 30%, with a greater risk reduction the longer oral contraceptives were used. What’s even better is that the protective effect against endometrial cancer persists for many years even after a woman stops using oral contraceptives.
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Ovarian cancer: Study found more than 50% of risk reduction among women who use oral contraceptives. Similar to endometrial cancer, the protective effect can last for up to 30 years even the women stop using oral contraceptives.
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