Combined oral contraceptives (COCs) are pills containing two hormones — estrogen and progestogen. There are many myths around them, most of them based on fears and rumors. Let’s take a look at the actual truth about COCs. Spoiler alert: Something did turn out to be true! ## COCs cause infertility On the contrary, it is extremely easy to conceive a child in the first year after you stop taking COCs. The ovaries "rest" while taking the pills, since ovulation does not occur. Plus, the hormonal background settles and the risk of endometriosis decreases. ## COCs make you fat Women really did gain weight with the first hormonal contraceptives, but modern ones contain small doses of hormones. Studies have proven that today’s COCs ===do not cause weight gain. On the contrary, some COCs even contribute to weight loss. However, contraceptives can provoke the accumulation of fluid in the tissues before menstruation, which really increases body weight. ## COCs reduce libido In rare cases, there may indeed be a decrease in libido. As a rule, this happens only when you start taking them. This is because a woman's body adapts to taking birth control pills, so a decrease in libido can be observed only in the first months. Antiandrogenic activity may occur upon use of pronounced therapeutic effect drugs, which also partly suppresses libido. But there are contraceptives, for example, based on an almost natural hormone, that is nearly completely devoid of this side effect. However, it is worth remembering that a woman's libido is a rather complicated aspect, and not everything depends only on hormones. Taking COCs is a method of preventing breast and cervical cancer. Studies have found and confirmed that hormonal contraceptives reduce the likelihood of developing endometrial and ovarian cancer. The "protective" effect persists for several years after the drug is stopped. The risk of developing endometrial cancer is reduced by 50%, and the risk of colon cancer and ovarian cancer is reduced by 30%. Oral contraceptives do not affect the development of breast cancer in any way — they neither increase nor decrease such risk. Cervical cancer is only cancer with a proven viral nature. This means that no contraceptives can affect its occurrence. However, COCs help in the prevention of ovarian cysts, uterine fibroids and other common female problems. ## COCs don’t get rid of acne It has been found that androgens (male sex hormones) increase the activity of the sebaceous glands and the secretion of sebum. Some COCs contain progestins with an antiandrogenic effect, which help to cope with acne. ## COCs increase the risk of thrombus It is true that the formation of a thrombus (or blood clots) inside the vessels is well connected with increased activity of the blood coagulation system, caused by COCs. The possibility of such complications increases with the presence of risk factors (age over 35, smoking, arterial hypertension, obesity). It largely depends on the dose of estrogen that is part of the contraceptive. However, it is generally agreed that low-dose and micro-dose COCs do not cause blood clots inside the vessels for healthy women. ## Long-term use of COCs can postpone menopause COCs help women feel better when close to menopause and protect bones from brittleness and osteoporosis. Hot flashes before menopause are almost absent or stop altogether when hormonal contraceptives are being taken. ## Missing a single COC tablet cannot lead to pregnancy If guidelines are not followed when taking oral contraceptives, it is quite possible to become pregnant. In case a woman forgets to take the pill, she should take it as soon as she remembers and uses barrier methods of contraception within seven days. Pills must be taken regularly, and preferably at the same time. ## COCs can push back or accelerate the onset of menstruation The birth control pill is sometimes used to "schedule" periods. Your gynecologist may tell you how to do it correctly so it’s not harmful. However, this is not often recommended. When choosing a contraceptive, it is important to consider its indications and contraindications, effectiveness, and acceptability as well as the woman's age, health history, and reproductive system. Currently, there is no 100% effective contraceptive that can be prescribed to all women without risk to their health. Therefore, if you decide to take COCs, it is very important to find “your” pill. Choose the dose of hormones that is right for you, depending on your hormonal balance and the general characteristics of your body.