Myths and Misconceptions about Contraception
Dr. Sharon Quayle discusses the common misconceptions about contraception.
Featured Speaker:
Sharon Quayle, MD
With more than 25 years of experience in OB/GYN, Dr. Sharon Quayle has practiced privately in Rockland County, in the U.S. Navy and in an academic setting at Columbia University Medical Center. In 2018, Dr. Quayle joined Hudson Center for Women’s Health and was appointed Assistant Director of Obstetrics and Gynecology at Montefiore Nyack Hospital. Dr. Quayle is dedicated to providing the highest quality obstetrical care. She also provides a full range of gynecologic care to individuals of all ages, from adolescence to postmenopause. Transcription:
Myths and Misconceptions about Contraception
Alyne Ellis (Host): When it comes to getting pregnant, many people don’t know the whole truth. There are many myths and misconceptions about birth control and confusion about how you can conceive. We’ll talk about this today with Dr. Sharon Quayle, the Assistant Director of Obstetrics and Gynecology at Montefiore Nyack Hospital. This is Health Track, the podcast from Montefiore Nyack Hospital. I’m Alyne Ellis. So, Dr. Quayle, do most people make good choices when it comes to contraception?
Sharon Quayle, MD (Guest): A lot of patients choose methods that aren’t the most effective. So, the most effective methods of contraception are long acting reversible contraception. That includes the IUD and the implant that goes into your arm. That type of contraception is actually recommended by the American College of OBGYN and the American Academy of Pediatrics as a primary choice over oral contraceptives.
Host: So, when we deal with the myths though that kind of keep people from making that choice; what about withdrawal as an effective method of contraception?
Dr. Quayle: So, withdrawal really is much less effective than other forms of contraception. It depends on first of all, the motivation of the man to actually withdraw before he ejaculates. Plus when couples are having sex, a little bit of semen can leak out before the man actually comes and that semen – it only takes one sperm to make a woman pregnant. So, that’s really not that effective compared to other available methods of contraception.
Host: A lot of teenagers in particular I think are a little wary of using IUDs and maybe older women also. Is that a dangerous method to use?
Dr. Quayle: Actually it’s one of the most effective methods of contraception and a lot of people have the misconception that IUDs can cause infertility or some other very bad health consequence. I actually recommended both my daughters who are now in their 20s get IUDs because it’s such an effective and safe form of contraception. There is only a very tiny risk of infection and in fact, it’s not increased using the IUD. Because of the way a lot of the IUDs work, a lot of IUDs have progesterone in them, and the progesterone works to thicken cervical mucus and that actually decreases the risk of infection because the infection can’t penetrate up into the uterus.
It does not increase the risk of infertility. There is only a very small risk of perforation of the IUD and all these risks are much smaller than having an unintended pregnancy and even having a lot of serious complications during pregnancy.
Host: And if you were to have a problem like that, you’d have a symptom that would take you to the doctor.
Dr. Quayle: Absolutely.
Host: So, let’s talk about oral contraceptives for a minute and the perception that they might cause cancer.
Dr. Quayle: Oral contraceptives don’t increase the risk of cancer. There were a few studies several years ago that questioned possible increased risk of breast cancer but that’s really in debate still. What we do know is that women who use oral contraceptives for about five years or more reduce their risk of ovarian cancer by 50%. Many gynecologic oncologists actually recommend women go on oral contraceptives to decrease their risk of ovarian cancer.
Host: What about weight gain though? I’ve heard you can gain weight on those things.
Dr. Quayle: So, in the past, we used higher dose pills and it is common for women especially young women to experience some bloating the first few months that they start on the birth control pill. Studies indicate that there actually is no increased risk of weight gain using oral contraceptives or IUDs that have hormone in them.
Host: And what about if you miss a period, is that something that you can worry about when you are taking these?
Dr. Quayle: I think that that does bother a lot of women but there’s really no medical reason that you need to have a period when you are on an oral contraceptive or when you are using an IUD that has hormone in it. So, there really is no risk to missing your period. Some patients come to me and they say oh I feel like I need to have that monthly period to clean out my system. But there’s really no medical basis for having to have a period when you are on a hormonal method of contraception.
Host: So, is birth control 100% effective no matter what you use?
Dr. Quayle: The most effective forms of contraception are the IUD and the Nexplanon which is the hormonal implant. That’s why those two methods are recommended to young women and teenagers as a top choice by the American College of OBGYN and the American Academy of Pediatrics. At that time in your life, you are the most fertile and in the United States, 50% of all pregnancies are unplanned. So, those are the top choices. That being said, oral contraceptives is also a good choice and has definite benefits. They are about 91% effective. Then there’s Depo-Provera which is a shot in the arm. You can receive that once every three months. That effectiveness is about 92 to 93%. And then everything else like condoms, withdrawal, natural family planning; the risk of getting pregnant increases with all those compared to the ones I just mentioned.
Host: So, when someone comes to you for advice on contraception; what do you look at to decide which one is right for that particular person?
Dr. Quayle: Generally if the person is very healthy, I go over all the choices with them. I give them the benefits and try to address any concerns that they have, potential risks of each method. So, most healthy young women could actually choose any of the methods that we’ve discussed. There are certain medical situations where a patient might not be a candidate, for instance if somebody is 35 and smoking; they are not a candidate for oral contraceptives. If they have high blood pressure, we would not give oral contraceptives. I try to give people a variety of choices.
Host: Now what about if a teenager comes to you or even possibly a parent with a teenager which is probably more unusual. I think there’s always the perception that teenagers who get contraceptives might perhaps be more promiscuous. Do you have a comment on that?
Dr. Quayle: Well, I think that is a concern of a lot of mothers who bring in their teenagers. And actually I do quite frequently see teenagers and mothers together. Depending on the situation, I will interview the mom and the patient together and then often I will send – most of the time, I will send the mother out of the room and have a discussion again with the daughter because she may not want to reveal certain information in front of her mom. There is sometimes a hesitancy to allow a young woman to have access to contraception. But studies have actually been done on this. Having access to contraception does not increase the likelihood that a young woman will become sexually active or have more partners.
What we have seen over the past recent years is that the number of unintended pregnancies in young women is decreasing and this is probably related to the availability of long acting contraception.
Host: Is there anything else you would like to add?
Dr. Quayle: If people want further information about contraceptive choices and what’s right for them; I would like to give a few websites. One is Planned Parenthood which has an excellent information about contraceptive choices. The other is our professional organization, which is the American College of OBGYN, and you can look it up under www.acog.org. The third is the Bedsider. And all of these have great information about contraceptive choice.
Host: Thank you Dr. Quayle for your time today. Dr. Sharon Quayle is the Assistant Director of Obstetrics and Gynecology at Montefiore Nyack Hospital. For more information on contraception please visit www.nyackobgyn.com or call 845-353-1441 for more information or to schedule a consultation appointment. That wraps up this episode of our Health Track podcast. If you found this podcast helpful, please share it on your social medial channels and be sure to check out the entire podcast library for topics of interest to you. I’m Alyne Ellis. Thanks for listening.
Myths and Misconceptions about Contraception
Alyne Ellis (Host): When it comes to getting pregnant, many people don’t know the whole truth. There are many myths and misconceptions about birth control and confusion about how you can conceive. We’ll talk about this today with Dr. Sharon Quayle, the Assistant Director of Obstetrics and Gynecology at Montefiore Nyack Hospital. This is Health Track, the podcast from Montefiore Nyack Hospital. I’m Alyne Ellis. So, Dr. Quayle, do most people make good choices when it comes to contraception?
Sharon Quayle, MD (Guest): A lot of patients choose methods that aren’t the most effective. So, the most effective methods of contraception are long acting reversible contraception. That includes the IUD and the implant that goes into your arm. That type of contraception is actually recommended by the American College of OBGYN and the American Academy of Pediatrics as a primary choice over oral contraceptives.
Host: So, when we deal with the myths though that kind of keep people from making that choice; what about withdrawal as an effective method of contraception?
Dr. Quayle: So, withdrawal really is much less effective than other forms of contraception. It depends on first of all, the motivation of the man to actually withdraw before he ejaculates. Plus when couples are having sex, a little bit of semen can leak out before the man actually comes and that semen – it only takes one sperm to make a woman pregnant. So, that’s really not that effective compared to other available methods of contraception.
Host: A lot of teenagers in particular I think are a little wary of using IUDs and maybe older women also. Is that a dangerous method to use?
Dr. Quayle: Actually it’s one of the most effective methods of contraception and a lot of people have the misconception that IUDs can cause infertility or some other very bad health consequence. I actually recommended both my daughters who are now in their 20s get IUDs because it’s such an effective and safe form of contraception. There is only a very tiny risk of infection and in fact, it’s not increased using the IUD. Because of the way a lot of the IUDs work, a lot of IUDs have progesterone in them, and the progesterone works to thicken cervical mucus and that actually decreases the risk of infection because the infection can’t penetrate up into the uterus.
It does not increase the risk of infertility. There is only a very small risk of perforation of the IUD and all these risks are much smaller than having an unintended pregnancy and even having a lot of serious complications during pregnancy.
Host: And if you were to have a problem like that, you’d have a symptom that would take you to the doctor.
Dr. Quayle: Absolutely.
Host: So, let’s talk about oral contraceptives for a minute and the perception that they might cause cancer.
Dr. Quayle: Oral contraceptives don’t increase the risk of cancer. There were a few studies several years ago that questioned possible increased risk of breast cancer but that’s really in debate still. What we do know is that women who use oral contraceptives for about five years or more reduce their risk of ovarian cancer by 50%. Many gynecologic oncologists actually recommend women go on oral contraceptives to decrease their risk of ovarian cancer.
Host: What about weight gain though? I’ve heard you can gain weight on those things.
Dr. Quayle: So, in the past, we used higher dose pills and it is common for women especially young women to experience some bloating the first few months that they start on the birth control pill. Studies indicate that there actually is no increased risk of weight gain using oral contraceptives or IUDs that have hormone in them.
Host: And what about if you miss a period, is that something that you can worry about when you are taking these?
Dr. Quayle: I think that that does bother a lot of women but there’s really no medical reason that you need to have a period when you are on an oral contraceptive or when you are using an IUD that has hormone in it. So, there really is no risk to missing your period. Some patients come to me and they say oh I feel like I need to have that monthly period to clean out my system. But there’s really no medical basis for having to have a period when you are on a hormonal method of contraception.
Host: So, is birth control 100% effective no matter what you use?
Dr. Quayle: The most effective forms of contraception are the IUD and the Nexplanon which is the hormonal implant. That’s why those two methods are recommended to young women and teenagers as a top choice by the American College of OBGYN and the American Academy of Pediatrics. At that time in your life, you are the most fertile and in the United States, 50% of all pregnancies are unplanned. So, those are the top choices. That being said, oral contraceptives is also a good choice and has definite benefits. They are about 91% effective. Then there’s Depo-Provera which is a shot in the arm. You can receive that once every three months. That effectiveness is about 92 to 93%. And then everything else like condoms, withdrawal, natural family planning; the risk of getting pregnant increases with all those compared to the ones I just mentioned.
Host: So, when someone comes to you for advice on contraception; what do you look at to decide which one is right for that particular person?
Dr. Quayle: Generally if the person is very healthy, I go over all the choices with them. I give them the benefits and try to address any concerns that they have, potential risks of each method. So, most healthy young women could actually choose any of the methods that we’ve discussed. There are certain medical situations where a patient might not be a candidate, for instance if somebody is 35 and smoking; they are not a candidate for oral contraceptives. If they have high blood pressure, we would not give oral contraceptives. I try to give people a variety of choices.
Host: Now what about if a teenager comes to you or even possibly a parent with a teenager which is probably more unusual. I think there’s always the perception that teenagers who get contraceptives might perhaps be more promiscuous. Do you have a comment on that?
Dr. Quayle: Well, I think that is a concern of a lot of mothers who bring in their teenagers. And actually I do quite frequently see teenagers and mothers together. Depending on the situation, I will interview the mom and the patient together and then often I will send – most of the time, I will send the mother out of the room and have a discussion again with the daughter because she may not want to reveal certain information in front of her mom. There is sometimes a hesitancy to allow a young woman to have access to contraception. But studies have actually been done on this. Having access to contraception does not increase the likelihood that a young woman will become sexually active or have more partners.
What we have seen over the past recent years is that the number of unintended pregnancies in young women is decreasing and this is probably related to the availability of long acting contraception.
Host: Is there anything else you would like to add?
Dr. Quayle: If people want further information about contraceptive choices and what’s right for them; I would like to give a few websites. One is Planned Parenthood which has an excellent information about contraceptive choices. The other is our professional organization, which is the American College of OBGYN, and you can look it up under www.acog.org. The third is the Bedsider. And all of these have great information about contraceptive choice.
Host: Thank you Dr. Quayle for your time today. Dr. Sharon Quayle is the Assistant Director of Obstetrics and Gynecology at Montefiore Nyack Hospital. For more information on contraception please visit www.nyackobgyn.com or call 845-353-1441 for more information or to schedule a consultation appointment. That wraps up this episode of our Health Track podcast. If you found this podcast helpful, please share it on your social medial channels and be sure to check out the entire podcast library for topics of interest to you. I’m Alyne Ellis. Thanks for listening.