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Ask the Gyno: Side Effects

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The upside of birth control: feeling protected against an unplanned pregnancy. The down side: those pesky side effects. But are they actually as bad as we think? I sat down with Kate White, M.D.—Director of the Family Planning Fellowship at Boston University and the hippest gyno around—to figure out the real deal about BC side effects. 

Amber: Okay, so in general, how much should girls be worried about birth control side effects?

Dr. Kate: First of all, while birth control can have side effects, it’s important to remember that not all side effects are bad! Some people use birth control deliberately for the side effects they like, things like reduction of menstrual cramps or less bleeding during periods. Other positive effects associated with some methods of birth control are clearer skin, and reduced risk of some cancers and other serious reproductive issues like endometriosis and pelvic inflammatory disease.

If you read through the pamphlet that comes with your birth control pills (or any other prescription method), you’ll read a whole long list of side effects. But the truth is, side effects listed like headaches and nausea are correlated with taking any kind of pill. So, all in all I’d say girls shouldn’t be that worried. 

Amber: What about weight gain? I know a lot of girls who will swear up and down that taking the pill made them gain weight. 

Dr. Kate: There are lots of good studies of birth control pills compared against placebo pills, and women’s weight changes are the same in each group—meaning the research shows the pill isn’t necessarily associated with weight gain. In fact, as many women lose weight on the pill as gain. One thing that’s important to remember is that often there are other things going on in your life when you get on birth control and those lifestyle changes can cause weight gain…it’s not necessarily the pill. A lot of girls start birth control pills around the same time they start dating someone regularly. And what happens when you start dating someone regularly? You may go out to eat more, or exercise less because you’re spending time with your new guy, or even eat more junk food. It’s these life style changes that are likely more to blame for weight gain.

Amber: When you hear horror stories from your friends though, it’s a tough sell for contraception. 

Dr. Kate: All women’s bodies are different, and while effectiveness of a method doesn’t change from woman to woman, side effects do. This means that just because your girlfriend had one experience on a method doesn’t mean you will have that same one. 

Amber: What if you start a new method and are experiencing side effects you don’t like?

Dr. Kate: Side effects are highest in the first 3-6 months of using any method. After that, your body adjusts. So if you can ride out that initial period, you’ll likely be okay. But if you’re really miserable and you don’t want to wait that long, then it’s okay to switch. As a doctor, I listen to my patients—even if what they are saying goes against the research I’ve read. A good provider should listen to their patient’s concerns, and help them switch methods. You should always feel that you are choosing the method that you’re on. 

What’s really important though is that you don’t just stop a method on your own and then make an appointment with your doctor in a few months to start a new one. Women are at extremely high risk of becoming pregnant when they’re in between methods. So if you do want to stop one, be sure to talk to your gyno first, or at least use condoms consistently while you’re waiting for your appointment.

Amber: What else is important for all girls to know about birth control and side effects?

Dr. Kate: I think some girls put side effects and adverse effects in one bucket, and think that if they’re having side effects it means birth control is unhealthy or damaging their body, but that’s not true. Side effects are annoying, but not dangerous. In general, birth control is very safe. When you see headlines about a blood clot caused by birth control, that’s likely true. But the other side of the story is that women are also at a higher risk for blood clots when they’re pregnant. The risks to your health from pregnancy are much higher than any birth control—but the media doesn’t always tell that side of the story….

Want to learn more about all the methods out there? Check out our Birth Control Explorer and compare/contract each method. Ready to talk to a doc? Find a clinic or health care provider using our Find a Health Center feature!

Author: Amber M.
Teenagers sitting on a tree limb

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