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13 Things Most People Get Wrong About Birth Control

Your pill maybe doesn't need its own alarm clock.

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1. You need to take the pill at the same time every day or it's not effective.

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Not unless you actually can't remember it without an alarm. As long as you take the pill once a day, the effectiveness will stay the same, Dr. Lauren Streicher, OB-GYN and author of Sex Rx, tells BuzzFeed Life. In fact, even if you miss one pill, the recommendation is to take two pills the following day — there's no need for backup birth control unless you miss more than one in a row.

The exception: If you're taking the progestin-only minipill (an estrogen-free option that's not super common). With this pill, you do need to take it at the same time each day or it's less effective. The only other caution is when starting a new pill pack. Since you just had a week of inactive pills, it's more important that you start your new pack on time and on the right day. Taking it too late may reduce its effectiveness, says Streicher.

2. Birth control = all of the hormones.

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Well, not necessarily. The type and amount of hormones in each method varies, so the one you choose should be a very individual decision, Dr. Alyssa Dweck, OB-GYN and coauthor of V Is for Vagina, tells BuzzFeed Life. And if you want or need to go hormone-free, there are options! You can try the copper IUD, a barrier method (like condoms or diaphragms) or fertility awareness–based methods, which involve carefully tracking your cycles and your body's patterns to avoid unprotected sex when you're ovulating.

3. The pill makes you gain tons of weight.

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Not true, says Streicher. A large review from 2014 didn't find sufficient evidence that birth control pills or patches cause weight gain, though a 2009 study did find that people using the birth control shot typically gain weight. Of course, some people gain weight and some people lose weight while taking the pill, but there's not enough evidence to blame it on the birth control.

4. Being on birth control too long can mess with your fertility.

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There's no research to suggest that birth control itself can impact your future fertility, says Dweck. So why do some people have trouble getting pregnant after taking it for 20 years?

Well, increased age would certainly be a factor — if you're 40 when you stop the pill, then yes, you'll probably have a harder time getting pregnant. And if you went on birth control to deal with irregular cycles or a condition like PCOS or endometriosis, those issues could return once you stop birth control, and they can also impact your fertility, says Dweck. Here's lots more you should know about fertility.

5. You should really take a break from birth control every once in a while.

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Only if you want to get pregnant. There's no medical reason to take a break from your birth control method if you're in good health and having no problems with it, say the experts. Even if you're not having sex right now. In fact, stopping and starting may actually put you at risk for those introductory side effects all over again. The only exception here is the birth control shot, which is only recommended for use up to two years.

6. IUDs are only for people who've already had kids.

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Nope, pretty much anyone can get them, says Streicher. In fact, the American Academy of Pediatrics suggested IUDs and implants as “first-line contraceptive choices for adolescents" since they're so effective. Here's everything you need to know about IUDs.

7. Blood clots are usually caused by birth control.

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Actually, your risk of getting a blood clot while on birth control is LESS THAN your risk of getting one while pregnant or just after giving birth, says Streicher. Yes, being on birth control can raise your risk — from a 0.04% chance to a 0.18% chance. Still, birth control isn't the main cause of blood clots.

That said, if you have other risk factors (like a personal or family history of blood clots, smoking, obesity, high blood pressure, cardiovascular disease, migraines with aura, etc.) then definitely talk to your doctor about which birth control method would be best for you. They may recommend an IUD or condoms, which won't raise your risk.

8. You should stop using birth control a few months before you want to get pregnant so you can get all those hormones out of your system.

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Those hormones will be out of your system in a day or so with most methods, says Streicher. Plus, it's totally possible — and safe — to get pregnant right after you stop using birth control.

The only reason to stop birth control before you actually want to get pregnant is if you want to give yourself some time to start ovulating regularly. This can happen pretty much instantly, or it can take a few months — it really depends on the person and what their cycles were like before they started birth control, says Dweck. The exception here is the birth control shot. It can take 10 months or longer for ovulation to return to normal after stopping the shot, though research shows most people are back to normal by 12 months.

9. You have, like, a 2% chance of getting pregnant while on birth control.

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Actually, failure rates vary A LOT depending on the method. The failure rate is the percentage of people who will get pregnant in a given year while using this birth control, and it's usually different for perfect use (when used consistently and correctly) and typical use (when you also factor in people who use it inconsistently or incorrectly). Here are common failure rates from the Guttmacher Institute:

-For condoms: the failure rate is 2% with perfect use and 18% with typical use.

-For the pill, ring, and patch: the failure rate is less than 1% with perfect use and 9% with typical use.

-For the IUD and implants: the failure rate is less than 1% with perfect or typical use.

-For the shot: the failure rate is less than 1% with perfect use and 6% with typical use.

-For the diaphragm: the failure rate is 6% with perfect use and 12% with typical use.

-For the female condom: the failure rate is 5% with perfect use and 21% with typical use.

10. "Pulling out" is basically the same as not using any birth control.

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OK, it's not the best, but it's not as useless as you might think it is. The failure rate is 4% with perfect use and 22% with typical use. And because this method relies on removing a penis at a very crucial moment, it's probably safe to assume that most people fall into the typical use category. Still, that's only a little bit less effective than condoms are with typical use. But unlike condoms, this doesn't protect you against STIs.

11. People over 35 can't be on the pill.

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Nope, they totally can as long as they don't have any other factors that would put them at a higher risk of blood clots, says Dweck. But if you're also a smoker, are obese, have a personal or family history of blood clots, have high blood pressure, or other medical factors, you should not be on the pill. Talk to your doctor about what they recommend. One other precaution would be if you have breast cancer or a history of breast cancer, which might mean you can't use estrogen-containing birth control.

12. Grapefruit can make your birth control less effective.

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Not true at all. BUT grapefruit can interact with some types of birth control that contain the estrogen called ethinyl estradiol (like NuvaRing, Yasmin, Yaz, Ortho Tri-Cyclen, Ortho Tri-Cyclen Lo, Levora, and others). It won't make them less effective, but research shows that a chemical in the fruit can increase the amount of this estrogen in your bloodstream, and it's possible that could lead to side effects or health risks. So if you eat lots of grapefruit and you're on this type of birth control, talk to your doctor about the interaction.

13. Birth control is totally free now.

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Nope. Even though the Affordable Care Act says all FDA-approved birth control methods are covered without a co-pay as long as you have insurance, some insurance companies still aren't complying. Here's how to actually get your birth control for free.

This post has been updated to mention all fertility awareness-based methods, rather than just the rhythm method.

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