Times have changed since women going on birth control risked the pelvic infections of the Dalkon Shield or hormones dosed perilously high. Intrauterine devices (IUDs) have been redesigned to be very safe. The contraceptive sponge is almost risk free—though there are more effective ways to prevent pregnancy. Condoms are safe for everyone and are the only form of birth control that protects against sexually transmitted diseases (STDs). And the Pill is so safe and effective these days that it is available over-the-counter in some countries.
"The Pill is one of the most widely studied drugs; it has probably been studied more than aspirin," says Anne Foster-Rosales, MD, chief medical officer for Planned Parenthood Golden Gate and a professor at the University of California, San Francisco.
The Pill can be good for you
"There are profound and considerable noncontraceptive benefits for most methods," says Lee Shulman, MD, a professor at Northwestern University who is on the board of directors of the Association of Reproductive Health Professionals. Depending on the formula of the medication, the Pill can do the following.
- Help reduce menstrual bleeding for women at risk of anemia
- Reduce painful periods
- Cut back on the risk of uterine infection and ovarian cancer
- Treat PMS mood swings
- Help clear up mild to moderate acne
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But birth control still has risks
Most side effects of the Pill are minor, such as breast tenderness, headaches, or nausea, and they often subside after a few months. But rare, serious side effects include blood clots, heart attack, and stroke. Women who smoke or have any sort of heart problems should not use hormonal methods of birth control. (It's a good idea to ask to be screened for heart problems before starting one.) "It's critical that women realize that whether it's a birth control pill or baby aspirin, when they put a pill in their mouth there's a risk," says Dr. Schulman.
IUDs (intrauterine devices made of copper and/or plastic that provide years of continuous contraception) can spread an existing infection from the vagina to the uterus—which is why your doctor should test you for infections before the implantation procedure, and why IUDs are generally not recommended for those at higher risk for STDs, such as women with multiple partners. However, implanting a Mirena (one of two types of IUDs available currently in the U.S.) may actually help prevent infection by thickening the mucus that covers the cervix. (The thick mucus plugs the opening to the uterus and helps stop infections from getting in.)
Even with condoms, there's a risk: A very small percentage of people are allergic to latex but can use polyurethane condoms instead.
Then there's the risk that birth control won't work…
All birth control methods have a failure rate—even sterilization. Unless your method is abstinence, there's always a possibility that heterosexual sex could result in pregnancy. But the risk of failure per year is less than 1% for many methods, as opposed to the 85% chance of pregnancy if you don't use birth control.
The biggest reason for birth control failure is neglecting to use the method correctly or consistently.